Individual
MR. DEWITT RANDOLPH SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
5A ETHAN ALLEN DR, SUFFERN, NY 10901-1802
(845) 548-6567
Mailing address
8931 161ST ST, JAMAICA, NY 11432-6102
(845) 548-6567
(212) 526-6169
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000779
NY
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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