MEDICARE: MS. STEPHANIE SCOTTO OTR

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	225X00000X	Occupational Therapist	071256-1	NY
2	225XP0019X	Physical Rehabilitation Occupational Therapist	017256-1	NY
3	225XP0200X	Pediatric Occupational Therapist	017256-1	NY

General Provider Information

NPI Number	:	1053671784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE SCOTTO OTR

Provider Business Mailing Address
First Line	:	83 RADCLIFF RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-2611
Country	:	US
Telephone Number	:	917-284-3995
Fax Number	:

Provider Business Practice Location Address
First Line	:	83 RADCLIFF RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-2611
Country	:	US
Telephone Number	:	917-284-3995
Fax Number	:

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

Provider Enumeration Date	:	05/29/2012
Last Update Date	:	05/29/2012

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