Organization Name: | KATHERINE J SCOVILLE DO PC |
NPI Number: | 1700188836 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHERINE J. SCOVILLE (PRESIDENT) |
Mailing Address: | 311 North St Suite 307 White Plains |
State: | NY US |
Postal Code: | 106052217 |
Phone Number: | 9143589559 |
Fax Number: | 9143589560 |
NPI Enumeration Date: | 11/22/2010 |
NPI Last Update Date: | 03/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 258780 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |