MEDICARE: MRS. SARAH SCOTT

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	164W00000X	Licensed Practical Nurse	29339501	NY

General Provider Information

NPI Number	:	1164159562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH SCOTT

Provider Business Mailing Address
First Line	:	13508 117TH ST
Second Line	:
City	:	SOUTH OZONE PARK
State	:	NY
Zip	:	11420-3621
Country	:	US
Telephone Number	:	347-287-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 E GATE BLVD STE 201
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-2119
Country	:	US
Telephone Number	:	516-222-0092
Fax Number	:

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

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	08/04/2022

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Directions to “ MRS. SARAH SCOTT ” Practice Location

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