MEDICARE: SCOTT GOTTESFELD MD

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	207RC0000X	Cardiovascular Disease Physician	214602	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00411579	OTHER	NY	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0667910001	OTHER	NY	DME

General Provider Information

NPI Number	:	1366447971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT GOTTESFELD MD

Provider Business Mailing Address
First Line	:	110 S BEDFORD RD
Second Line	:	CARE MOUNT MEDICAL PC
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-3446
Country	:	US
Telephone Number	:	914-241-1050
Fax Number	:	914-242-1516

Provider Business Practice Location Address
First Line	:	111 BEDFORD RD
Second Line	:	CARE MOUNT MEDICAL PC
City	:	KATONAH
State	:	NY
Zip	:	10536-2115
Country	:	US
Telephone Number	:	914-232-3135
Fax Number	:	914-242-1516

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/11/2016

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Directions to “ SCOTT GOTTESFELD MD” Practice Location

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