Provider Demographics
NPI:1134199151
Name:SCOTTI, LOUIS (DPM)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:SCOTTI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 GIBBS POND RD
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2255
Mailing Address - Country:US
Mailing Address - Phone:631-979-0060
Mailing Address - Fax:631-724-4460
Practice Address - Street 1:130 GIBBS POND RD
Practice Address - Street 2:
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-2255
Practice Address - Country:US
Practice Address - Phone:631-979-0060
Practice Address - Fax:631-724-4460
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003439213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP35842Medicare PIN
NYT51075Medicare UPIN