Individual provider · Type 1 NPI

Miccal A. Scott-Lyew, AGPC-NP

Primary Care Nurse Practitioner · Montclair, NJ

NPI number 1720673171 Active

Practice location

28 Valley Rd # 148
Montclair, NJ 07042-2709

Fax (855) 998-4358

Mailing address

34 Mountain Blvd Ste 203
Warren, NJ 07059-2640

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X26NJO1148500 (NJ)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1720673171

Miccal A. Scott-Lyew, AGPC-NP's National Provider Identifier is 1720673171, issued on Mar 8, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Montclair, NJ. The record was last updated on Jul 7, 2023.