MEDICARE: MRS. TERRY ADERONKE SCOTLAND

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	207Q00000X	Family Medicine Physician	245304-1	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	:	1558552778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRY ADERONKE SCOTLAND

Provider Business Mailing Address
First Line	:	700 FORT WASHINGTON AVE
Second Line	:	APT. 2B
City	:	NEW YORK
State	:	NY
Zip	:	10040-3704
Country	:	US
Telephone Number	:	347-565-3973
Fax Number	:

Provider Business Practice Location Address
First Line	:	1996 AMSTERDAM AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-5058
Country	:	US
Telephone Number	:	212-781-7979
Fax Number	:	212-781-7963

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/21/2009

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