Provider Demographics
NPI:1508627019
Name:SCOTT, ELDEN
Entity Type:Individual
Prefix:
First Name:ELDEN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7708 CITY AVE STE 219
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2000
Mailing Address - Country:US
Mailing Address - Phone:215-596-0079
Mailing Address - Fax:
Practice Address - Street 1:7708 CITY AVE STE 219
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2000
Practice Address - Country:US
Practice Address - Phone:215-596-0079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide