Provider Demographics
NPI:1275847022
Name:SCOTT, EILEEN M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:M
Other - Last Name:EDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7776
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-7776
Mailing Address - Country:US
Mailing Address - Phone:888-985-2727
Mailing Address - Fax:856-779-0211
Practice Address - Street 1:9815 ROOSEVELT BLVD UNIT J
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1035
Practice Address - Country:US
Practice Address - Phone:888-985-2727
Practice Address - Fax:856-779-0211
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003325363AM0700X
PAMA059265363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical