Provider Demographics
NPI:1750318515
Name:STRATTON-SMITH, SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:STRATTON-SMITH
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 1:3173 CHILI AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-5400
Mailing Address - Country:US
Mailing Address - Phone:585-889-0750
Mailing Address - Fax:585-889-0759
Practice Address - Street 1:3173 CHILI AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5400
Practice Address - Country:US
Practice Address - Phone:585-889-0750
Practice Address - Fax:585-889-0759
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01685565Medicaid
NYRA0102-GRP:BA0017Medicare PIN
NY01685565Medicaid
NYRA0102-GRP:BA0017Medicare PIN
G35670Medicare UPIN