MEDICARE: MRS. LISA M WESTCOTT NP

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	363LF0000X	Family Nurse Practitioner	F333074	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	:	1861499196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA M WESTCOTT NP

Provider Business Mailing Address
First Line	:	750 E ADAMS ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-2306
Country	:	US
Telephone Number	:	315-464-5612
Fax Number	:

Provider Business Practice Location Address
First Line	:	830 WASHINGTON ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-4034
Country	:	US
Telephone Number	:	315-785-4102
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	09/25/2015

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