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General NPI Number Information
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NPI Number | 1780283242
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Entity Type | Individual
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Provider Name | ELIZABETH MARIE SCALZO FNP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2020
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 111 BEACH DR
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City | WEST ISLIP
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State | NY
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Zip | 11795-4929
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Country | US
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Telephone | 314-178-6006
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Fax | 631-666-0684
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Provider Business Mailing Address
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Address Line | 96 HOLST DR W
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City | HUNTINGTON
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State | NY
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Zip | 11743-3940
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Country | US
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Telephone | 631-790-9387
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F346401-01
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License Number State | NY
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