MEDICARE: SCOTT S. ALTABET LCSW

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	1041C0700X	Clinical Social Worker	R032717	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467551226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT S. ALTABET LCSW

Provider Business Mailing Address
First Line	:	PO BOX 708
Second Line	:
City	:	MAMARONECK
State	:	NY
Zip	:	10543-0708
Country	:	US
Telephone Number	:	917-208-4273
Fax Number	:	718-904-9648

Provider Business Practice Location Address
First Line	:	2436 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5916
Country	:	US
Telephone Number	:	917-208-4273
Fax Number	:	914-713-0337

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/12/2021

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Directions to “ SCOTT S. ALTABET LCSW” Practice Location

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