MEDICARE: CALEB 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	103T00000X	Psychologist	028060	NY

General Provider Information

NPI Number	:	1275117897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB SCOTT

Provider Business Mailing Address
First Line	:	17 PIKE ST APT 4C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-7048
Country	:	US
Telephone Number	:	949-338-0224
Fax Number	:

Provider Business Practice Location Address
First Line	:	760 BROADWAY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-5317
Country	:	US
Telephone Number	:	718-963-8000
Fax Number	:

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

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	03/16/2026

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Directions to “ CALEB SCOTT ” Practice Location

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