Provider Demographics
NPI:1700026945
Name:MORGAN, SCOTT ALAN
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:MORGAN
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 1:8881 STATE ROUTE 97
Mailing Address - Street 2:
Mailing Address - City:CALLICOON
Mailing Address - State:NY
Mailing Address - Zip Code:12723-5052
Mailing Address - Country:US
Mailing Address - Phone:845-887-5693
Mailing Address - Fax:845-887-5694
Practice Address - Street 1:8881 STATE ROUTE 97
Practice Address - Street 2:
Practice Address - City:CALLICOON
Practice Address - State:NY
Practice Address - Zip Code:12723-5052
Practice Address - Country:US
Practice Address - Phone:845-887-5693
Practice Address - Fax:845-887-5694
Is Sole Proprietor?:No
Enumeration Date:2009-02-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily