Individual
SCOTT E CHARNITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
TX
363AM0700X
Medical Physician Assistant
Primary
000970
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090970
CONNECTICARE
—
01
—
230590
PREFERRED ONE
—
01
—
290000970CT01
BLUE CROSS
—
01
—
2V3628
HEALTHNET MEDICAID
—
Enumeration date
11/09/2005
Last updated
12/06/2007
Update your record
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