Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N0049101 | NY |
NPI | 1104963503 |
---|---|
Provider Name | Aniello Scotti |
First Address | Shirley, NY 11967-3415 |
Second Address | Shirley, NY 11967-3415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 29/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01632860 | (05) | NY |
480027284 | RAILROAD MEDICARE (01) | NY |
U43252 | (02) | NY |