Provider Demographics
NPI:1760974109
Name:SCOTTI, LENA
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:SCOTTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-3114
Mailing Address - Country:US
Mailing Address - Phone:631-522-8147
Mailing Address - Fax:
Practice Address - Street 1:323 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-3114
Practice Address - Country:US
Practice Address - Phone:631-522-8147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker