Provider Demographics
NPI:1588724322
Name:DENARO, SCOTT
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:DENARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113-10 BEACH CHANNEL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694
Mailing Address - Country:US
Mailing Address - Phone:718-474-1234
Mailing Address - Fax:718-945-5809
Practice Address - Street 1:11310 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2209
Practice Address - Country:US
Practice Address - Phone:718-474-1234
Practice Address - Fax:718-945-5809
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY607319237700000X
NY5425-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist