Provider Demographics
NPI:1508942392
Name:HUBER, SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:HUBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5417
Mailing Address - Country:US
Mailing Address - Phone:732-775-5430
Mailing Address - Fax:
Practice Address - Street 1:501 7TH AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5417
Practice Address - Country:US
Practice Address - Phone:732-775-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00413200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU42907Medicare UPIN