Provider Demographics
NPI:1508096561
Name:SCOTT, MONIQUE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E EVERGREEN RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5146
Mailing Address - Country:US
Mailing Address - Phone:845-259-6910
Mailing Address - Fax:845-589-5171
Practice Address - Street 1:3 E EVERGREEN RD UNIT 101
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5146
Practice Address - Country:US
Practice Address - Phone:845-259-6910
Practice Address - Fax:845-589-5171
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401859363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health