MEDICARE: HENCY SCUTT N.P.,

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	208VP0000X	Pain Medicine Physician	F303384	NY
2	363LA2200X	Adult Health Nurse Practitioner	F303384	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	:	1972523207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENCY SCUTT N.P.,

Provider Business Mailing Address
First Line	:	355 OVINGTON AVE
Second Line	:	SUITE 203
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1483
Country	:	US
Telephone Number	:	718-759-0109
Fax Number	:	718-759-0101

Provider Business Practice Location Address
First Line	:	355 OVINGTON AVE
Second Line	:	SUITE 203
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1483
Country	:	US
Telephone Number	:	718-759-0109
Fax Number	:	718-759-0101

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	05/02/2016

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Directions to “ HENCY SCUTT N.P.,” Practice Location

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