Provider Demographics
NPI:1669532859
Name:SCRIBER, KENT C (EDD, ATC, PT)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:C
Last Name:SCRIBER
Suffix:
Gender:M
Credentials:EDD, ATC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 GUNDERMAN RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-8624
Mailing Address - Country:US
Mailing Address - Phone:607-272-1782
Mailing Address - Fax:
Practice Address - Street 1:14 HILL RD
Practice Address - Street 2:ITHACA COLLEGE
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-8629
Practice Address - Country:US
Practice Address - Phone:607-274-3178
Practice Address - Fax:607-274-1943
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000118-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer