Provider Demographics
NPI:1245268978
Name:NAVARRO, BRIAN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SCOTT
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:3757 CARMAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5418
Practice Address - Country:US
Practice Address - Phone:518-355-7063
Practice Address - Fax:518-357-0646
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2018-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY220579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02272475Medicaid
NY070125000008OtherFIDELIS
NY089441OtherMVP
NY000499866001OtherBSNENY
NY200090OtherSENIOR WHOLE HEALTH
NY7881625OtherAETNA
NY10060798OtherCDPHP
NY5038A1OtherEMPIRE BC
NY57700OtherGHI/HMO
NYDD0575Medicare ID - Type UnspecifiedUPSTATE MEDICARE
NY02272475Medicaid