Provider Demographics
NPI:1669597159
Name:CARDANY, SCOTT RYAN (OTRL)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:RYAN
Last Name:CARDANY
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 APPLE MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4742
Mailing Address - Country:US
Mailing Address - Phone:304-685-2775
Mailing Address - Fax:
Practice Address - Street 1:130 KAUFMAN DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2179
Practice Address - Country:US
Practice Address - Phone:304-363-4891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1105225X00000X
MD05553225X00000X
PAOC010354225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist