Provider Demographics
NPI:1699158014
Name:SCOTT, JOSHUA ERIC (PA-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ERIC
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NICOLLS RD
Mailing Address - Street 2:HSC T19 RM 020 STONY BROOK UNIVERSITY HOSPITAL
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:801-472-6818
Mailing Address - Fax:
Practice Address - Street 1:NICOLLS RD
Practice Address - Street 2:HSC T19 ROOM 020 STONY BROOK UNIVERSITY HOSPITAL
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:801-472-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018728363A00000X
TXPA10561363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant