Provider Demographics
NPI:1336160738
Name:SCOTTI, ALPHONSO A (PA-C)
Entity Type:Individual
Prefix:
First Name:ALPHONSO
Middle Name:A
Last Name:SCOTTI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:57 HAMPTON ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968
Mailing Address - Country:US
Mailing Address - Phone:631-283-1126
Mailing Address - Fax:631-283-7496
Practice Address - Street 1:470 PANTIGO ROAD
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937
Practice Address - Country:US
Practice Address - Phone:631-329-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2023-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011126363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant