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NPI Code Detail

MEDICARE: KENNETH SCOTT

MEDICARE:   KENNETH  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
1174400000XSpecialist721496NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1721496OTHERNYSTUDENTS WITH DISABILITIES (BIRTH-GRADES 2)

General Provider Information

NPI Number : 1255773818
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH SCOTT
Provider Business Mailing Address
First Line : 490 2ND AVE #15-F
Second Line :
City : NEW YORK
State : NY
Zip : 10016
Country : US
Telephone Number : 917-573-4489
Fax Number : 212-725-8223
Provider Business Practice Location Address
First Line : 490 2ND AVE APT 15F
Second Line :
City : NEW YORK
State : NY
Zip : 10016-9178
Country : US
Telephone Number : 917-573-4489
Fax Number : 212-725-8223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2013
Last Update Date : 07/24/2013

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Directions to “ KENNETH SCOTT ” Practice Location

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