Provider Demographics
NPI:1700016060
Name:FIRESTONE, SCOT MAURICE (BC-HIS, ACA)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:MAURICE
Last Name:FIRESTONE
Suffix:
Gender:M
Credentials:BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2661
Mailing Address - Country:US
Mailing Address - Phone:717-757-1970
Mailing Address - Fax:717-757-1971
Practice Address - Street 1:3412 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2661
Practice Address - Country:US
Practice Address - Phone:717-757-1970
Practice Address - Fax:717-757-1971
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2516237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist