Provider Demographics
NPI:1942390992
Name:SCOTT, GREGORY M (PT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:342 HAMBURG TPKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2162
Mailing Address - Country:US
Mailing Address - Phone:973-942-5904
Mailing Address - Fax:973-904-1779
Practice Address - Street 1:342 HAMBURG TPKE
Practice Address - Street 2:SUITE 108
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2162
Practice Address - Country:US
Practice Address - Phone:973-942-5904
Practice Address - Fax:973-904-1779
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA00214300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist