MEDICARE: MR. BRIAN L. SCOTT MA,CCC-SLP

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	235Z00000X	Speech-Language Pathologist	008979-1	NY

General Provider Information

NPI Number	:	1679722987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN L. SCOTT MA,CCC-SLP

Provider Business Mailing Address
First Line	:	1 HAVEN PLZ
Second Line	:	APT. 4E
City	:	NEW YORK
State	:	NY
Zip	:	10009-3904
Country	:	US
Telephone Number	:	212-614-0881
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 HAVEN PLZ
Second Line	:	APT. 4E
City	:	NEW YORK
State	:	NY
Zip	:	10009-3904
Country	:	US
Telephone Number	:	212-614-0881
Fax Number	:

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

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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Directions to “ MR. BRIAN L. SCOTT MA,CCC-SLP” Practice Location

Language	Start Address	Practice Location

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