Individual
SCOTT POTICHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-5561
(212) 426-5054
Mailing address
PO BOX 28082, NEW YORK, NY 10087-8082
(212) 987-3100
(212) 731-5210
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
431063
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04662406
—
NY
Enumeration date
10/19/2016
Last updated
04/12/2017
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