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Individual

SUSAN A SCAVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 OLD COUNTRY RD, SUITE 650, MINEOLA, NY 11501-4235
(516) 747-0105
(516) 280-2612
Mailing address
200 OLD COUNTRY RD, SUITE 650, MINEOLA, NY 11501-4235
(516) 747-0105
(516) 280-2612

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2059971
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010205997NY01
ANTHEM
NY
01
0407961
GHI
NY
01
160048628
RR MEDICARE
NY
01
1912086
UNITED HEALTHCARE
NY
01
2185065
AETNA HNO
NY
01
262689012
HORIZON
NY
01
2C8532
PHS (HEALTHNET)
NY
01
5009001003
CIGNA
NY
01
50Z161
EMPIRE PLAN
NY
01
5662762
AETNA PPO/POS
NY
01
71560
GHI HMO
NY
01
NS0003502
SELECT PRO
NY
01
P1297217
OXFORD
NY
Enumeration date
08/30/2006
Last updated
08/17/2008
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