MEDICARE: TIFFANY LYNN SCOTT M.D.

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	208000000X	Pediatrics Physician	36-134855	IL
2	208000000X	Pediatrics Physician	25MA10222500	NJ

General Provider Information

NPI Number	:	1356515597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY LYNN SCOTT M.D.

Provider Business Mailing Address
First Line	:	76 STIRLING RD STE 201
Second Line	:
City	:	WARREN
State	:	NJ
Zip	:	07059-5778
Country	:	US
Telephone Number	:	908-755-5437
Fax Number	:	908-755-6905

Provider Business Practice Location Address
First Line	:	76 STIRLING RD.
Second Line	:	SUITE 201
City	:	WARREN
State	:	NJ
Zip	:	07059
Country	:	US
Telephone Number	:	908-755-5437
Fax Number	:	908-755-6905

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

Provider Enumeration Date	:	04/18/2008
Last Update Date	:	06/10/2026

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