Provider Demographics
NPI:1942583026
Name:SCOTT, JEANNE M (RPA-C)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:M
Other - Last Name:CASTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:207 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1207
Mailing Address - Country:US
Mailing Address - Phone:516-660-1120
Mailing Address - Fax:516-746-6131
Practice Address - Street 1:27005 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1402
Practice Address - Country:US
Practice Address - Phone:516-470-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015019363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant