Provider Demographics
NPI:1598369506
Name:SCOTTO, JENNIFER EVA TKOCS
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:EVA TKOCS
Last Name:SCOTTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2624
Mailing Address - Country:US
Mailing Address - Phone:412-678-6769
Mailing Address - Fax:
Practice Address - Street 1:311 5TH AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2624
Practice Address - Country:US
Practice Address - Phone:412-678-6769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist