Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 059970 | NY |
NPI | 1053845263 |
---|---|
Provider Name | Scott Schames |
First Address | Monroe, NY 10950-2923 |
Second Address | Monroe, NY 10950-2923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2017 |
Last Update Date | 10/12/2021 |