Provider Demographics
NPI:1124382023
Name:HAMMERMAN, SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:HAMMERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E 68TH ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5995
Mailing Address - Country:US
Mailing Address - Phone:401-456-2315
Mailing Address - Fax:410-456-6449
Practice Address - Street 1:50 MAUDE ST FL 1
Practice Address - Street 2:DEPARTMENT OF DERMATOLOGY AND SKIN SURGERY
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4325
Practice Address - Country:US
Practice Address - Phone:401-456-2315
Practice Address - Fax:410-456-6449
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD13680207N00000X
IL036114905207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology