MEDICARE: DR. LIONEL F SCOTT PHD

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	103TC0700X	Clinical Psychologist	00124-1	NY

General Provider Information

NPI Number	:	1578669180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LIONEL F SCOTT PHD

Provider Business Mailing Address
First Line	:	820 BOYNTON AVE
Second Line	:	#3D
City	:	BRONX
State	:	NY
Zip	:	10473-4648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 BOYNTON AVE
Second Line	:	#3D
City	:	BRONX
State	:	NY
Zip	:	10473-4648
Country	:	US
Telephone Number	:	718-328-3436
Fax Number	:

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/21/2022

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