Provider Demographics
NPI:1326144387
Name:KAHN, SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:KAHN
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 1:243 NORTH RD
Mailing Address - Street 2:STE 304
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1172
Mailing Address - Country:US
Mailing Address - Phone:845-451-7251
Mailing Address - Fax:845-451-7757
Practice Address - Street 1:50 EASTDALE AVE N
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603
Practice Address - Country:US
Practice Address - Phone:845-437-5000
Practice Address - Fax:845-452-8857
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2012051208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01919382Medicaid
NK052D5310Medicare PIN
NY58T761Medicare ID - Type Unspecified