Basic Information
| Provider Information | |||||||||
| NPI: | 1104884568 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | ELAINE | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 ACEE DRIVE | ||||||||
| Address2: | |||||||||
| City: | NATRONA HEIGHTS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002235544 | ||||||||
| FaxNumber: | 7242943206 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 CARLISLE ST | ||||||||
| Address2: | |||||||||
| City: | NATRONA HEIGHTS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242267330 | ||||||||
| FaxNumber: | 7242267150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 04/06/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD025576E | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QG0300X | MD025576E | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 208100000X | MD025576E | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 204R00000X | MD025576E | PA | N | Allopathic & Osteopathic Physicians | Electrodiagnostic Medicine |
ID Information
| ID | Type | State | Issuer | Description | 250011653 | 01 | RR MEDICARE | OTHER | 0009899280003 | 05 | PA | MEDICAID | 151031 | 01 | BLUE SHIELD | OTHER | 722597 | 01 | BS | OTHER | 13553 | 01 | ELDER HEALTH | OTHER |