Provider Demographics
NPI:1205805926
Name:AUMENTA, SCOTT ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANDREW
Last Name:AUMENTA
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 1:1035 NORTH BLACK HORSE PIKE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094
Mailing Address - Country:US
Mailing Address - Phone:856-740-0200
Mailing Address - Fax:856-740-0202
Practice Address - Street 1:1035 NORTH BLACK HORSE PIKE
Practice Address - Street 2:SUITE 4
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094
Practice Address - Country:US
Practice Address - Phone:856-740-0200
Practice Address - Fax:856-740-0202
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00623000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00623000Medicare PIN
NJ0951564PEMedicare UPIN