Provider Demographics
NPI:1376772293
Name:PALOCY, SCOTT MATTHEW (LPN)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:MATTHEW
Last Name:PALOCY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CHESTNUT ST APT B10
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:NY
Mailing Address - Zip Code:13135-2424
Mailing Address - Country:US
Mailing Address - Phone:315-806-9300
Mailing Address - Fax:
Practice Address - Street 1:23 CHESTNUT STREET
Practice Address - Street 2:APT B-10
Practice Address - City:PHOENIX
Practice Address - State:NY
Practice Address - Zip Code:13135
Practice Address - Country:US
Practice Address - Phone:315-806-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292727-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse