Provider Demographics
NPI:1649420183
Name:ADLER, SCOTT JOSEPH (DPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:JOSEPH
Last Name:ADLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 77TH ST
Mailing Address - Street 2:#9C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6606
Mailing Address - Country:US
Mailing Address - Phone:212-333-7780
Mailing Address - Fax:
Practice Address - Street 1:584 BROADWAY
Practice Address - Street 2:SUITE 710
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3229
Practice Address - Country:US
Practice Address - Phone:212-941-0503
Practice Address - Fax:212-941-6195
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030626-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist