Jacquelyn Scott-Greaves
Individual provider Active NPI Specialist · Wingdale, NY
NPI 1487909487 · NPPES record last updated Jul 17, 2012
Key facts
- NPI
- 1487909487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 8 Nicole LN
Wingdale, NY 12594-1343 - Phone
- (917) 716-8836
- NPI assigned
- Jul 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
8 Nicole LN
Wingdale, NY 12594-1343
Mailing address
8 Nicole LN
Wingdale, NY 12594-1343
Other providers in Wingdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.