Provider Demographics
NPI:1033102231
Name:PIATT, SCOTT JUSTIN (RPA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JUSTIN
Last Name:PIATT
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CHRIST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NY
Mailing Address - Zip Code:14727-1202
Mailing Address - Country:US
Mailing Address - Phone:585-968-5647
Mailing Address - Fax:
Practice Address - Street 1:238 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1046
Practice Address - Country:US
Practice Address - Phone:585-593-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005651363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0271Medicare ID - Type Unspecified
NYS88704Medicare UPIN