Provider Demographics
NPI:1811986391
Name:STRAUSS, SCOTT R (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:59 OLD HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1342
Mailing Address - Country:US
Mailing Address - Phone:908-730-6363
Mailing Address - Fax:908-730-8185
Practice Address - Street 1:59 OLD HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1342
Practice Address - Country:US
Practice Address - Phone:908-730-6363
Practice Address - Fax:908-730-8185
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010895L207Q00000X
NJ25MB079990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018157180003Medicaid
PA0018157180003Medicaid
PAH22499Medicare UPIN