Provider Demographics
NPI:1699854638
Name:SVITEK, SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:SVITEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 COMMACK RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3457
Mailing Address - Country:US
Mailing Address - Phone:631-499-8282
Mailing Address - Fax:631-462-5462
Practice Address - Street 1:154 COMMACK RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3457
Practice Address - Country:US
Practice Address - Phone:631-499-8282
Practice Address - Fax:631-462-5462
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192623208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01697158Medicaid
457X11OtherEMPIRE BCBS
AP662OtherOXFORD