Basic Information
| Provider Information | |||||||||
| NPI: | 1518339860 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | SHARON | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8200 SHORE FRONT PKWY APT 11D | ||||||||
| Address2: | |||||||||
| City: | ROCKAWAY BEACH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 116932148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189456080 | ||||||||
| FaxNumber: | 7189456080 | ||||||||
| Practice Location | |||||||||
| Address1: | 3636 33RD ST STE 306 | ||||||||
| Address2: | |||||||||
| City: | LONG ISLAND CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111062329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446444325 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2015 | ||||||||
| LastUpdateDate: | 06/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 340122 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.