Provider Demographics
NPI:1851760094
Name:SCOTT, SYDNEY (PA-C)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
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 1:244 KENNEDY MEMORIAL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4538
Mailing Address - Country:US
Mailing Address - Phone:207-861-8030
Mailing Address - Fax:207-861-8317
Practice Address - Street 1:244 KENNEDY MEMORIAL DR STE 102
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4538
Practice Address - Country:US
Practice Address - Phone:207-861-8030
Practice Address - Fax:207-861-8317
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0001017363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant