Provider Demographics
NPI:1699295527
Name:LEMLY, SCOTT VINCENT
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:VINCENT
Last Name:LEMLY
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 1:600 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1468
Mailing Address - Country:US
Mailing Address - Phone:201-857-3737
Mailing Address - Fax:201-857-3707
Practice Address - Street 1:600 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1468
Practice Address - Country:US
Practice Address - Phone:201-857-3737
Practice Address - Fax:201-857-3707
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00143800237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist