Provider Demographics
NPI:1790716256
Name:STEIN, SCOTT EPHRAIM (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EPHRAIM
Last Name:STEIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 W HAMILTON ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6470
Mailing Address - Country:US
Mailing Address - Phone:610-776-1603
Mailing Address - Fax:610-776-0693
Practice Address - Street 1:1941 W HAMILTON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6470
Practice Address - Country:US
Practice Address - Phone:610-776-1603
Practice Address - Fax:610-776-0693
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000445L363AM0700X
PAMA003138L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA035866Medicare ID - Type UnspecifiedMEDICARE NUMBER
PAP00906Medicare UPIN