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Individual

LORETTA SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
275 CASTLETON AVE, STATEN ISLAND, NY 10301-2709
(718) 447-7800
Mailing address
99 LEVERETT AVE, STATEN ISLAND, NY 10308-1724
(718) 948-0138

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302486-1
NY
363LG0600X
Gerontology Nurse Practitioner
F340378-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01951055
NY
Enumeration date
01/10/2006
Last updated
03/09/2009
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