Provider Demographics
NPI:1346474418
Name:SCOTT B WELLS MD PC
Entity Type:Organization
Organization Name:SCOTT B WELLS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-289-4400
Mailing Address - Street 1:655 PARK AVE
Mailing Address - Street 2:NETC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5985
Mailing Address - Country:US
Mailing Address - Phone:212-794-3900
Mailing Address - Fax:212-794-0760
Practice Address - Street 1:655 PARK AVE
Practice Address - Street 2:NETC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5985
Practice Address - Country:US
Practice Address - Phone:212-794-3900
Practice Address - Fax:212-794-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty