MEDICARE: SCOTT JUSTIN PIATT RPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	005651	NY

General Provider Information

NPI Number	:	1033102231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT JUSTIN PIATT RPA

Provider Business Mailing Address
First Line	:	8 CHRIST VIEW DR
Second Line	:
City	:	CUBA
State	:	NY
Zip	:	14727-1202
Country	:	US
Telephone Number	:	585-968-5647
Fax Number	:

Provider Business Practice Location Address
First Line	:	238 N MAIN ST
Second Line	:
City	:	WELLSVILLE
State	:	NY
Zip	:	14895-1046
Country	:	US
Telephone Number	:	585-593-0400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/22/2008

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