Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | $$$$$$$$$ | NY |
NPI | 1013936301 |
---|---|
Provider Name | Dr. Richard Scriven |
First Address | Stony Brook, NY 11790 |
Second Address | East Setauket, NY 11733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01961893 | (05) | NY |
206H61 | EMPIRE BC.BS (01) | NY |
7203094 | AETNA (01) | NY |
H02043 | (02) | NY |