Provider Demographics
NPI:1962724310
Name:SCOVOTTI, MARK STEVEN (RPH)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:SCOVOTTI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 ROUTE 292
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531-5541
Mailing Address - Country:US
Mailing Address - Phone:914-447-0471
Mailing Address - Fax:
Practice Address - Street 1:100 S BEDFORD RD STE 390
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3436
Practice Address - Country:US
Practice Address - Phone:800-361-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034533-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist