Provider Demographics
NPI:1205847308
Name:LINDSAY, SCOTT RICHARD (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:RICHARD
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WATERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1169
Mailing Address - Country:US
Mailing Address - Phone:631-513-9475
Mailing Address - Fax:631-689-5828
Practice Address - Street 1:7 WATERVIEW DR
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1169
Practice Address - Country:US
Practice Address - Phone:631-513-9475
Practice Address - Fax:631-689-5828
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019823-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQK8522Medicare ID - Type Unspecified