Provider Demographics
NPI:1679761803
Name:SCOTT V. RANKIN, M.D., P.C.
Entity Type:Organization
Organization Name:SCOTT V. RANKIN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-223-4759
Mailing Address - Street 1:276 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1042
Mailing Address - Country:US
Mailing Address - Phone:516-223-4759
Mailing Address - Fax:516-223-5712
Practice Address - Street 1:276 MOORE AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-1042
Practice Address - Country:US
Practice Address - Phone:516-223-4759
Practice Address - Fax:516-223-5712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191674207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEZ191Medicare PIN
NYF92310Medicare UPIN