Provider Demographics
NPI:1346439429
Name:SCOTT WHITMAN DPM PLLC
Entity Type:Organization
Organization Name:SCOTT WHITMAN DPM PLLC
Other - Org Name:NORTHEAST FOOTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:WHITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-279-1669
Mailing Address - Street 1:1663 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4048
Mailing Address - Country:US
Mailing Address - Phone:845-279-1669
Mailing Address - Fax:845-279-8084
Practice Address - Street 1:1663 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4048
Practice Address - Country:US
Practice Address - Phone:845-279-1669
Practice Address - Fax:845-279-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005815213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPWW731Medicare PIN
NY5425700001Medicare NSC