Provider Demographics
NPI:1689962458
Name:IKEDA, SCOTT R (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:IKEDA
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:55 WATER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0010
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:233 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4924
Practice Address - Country:US
Practice Address - Phone:718-826-5900
Practice Address - Fax:718-826-5860
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2025-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY262090-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine