Basic Information
| Provider Information | |||||||||
| NPI: | 1518922210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | JANEL | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 N STOCKTON AVE | ||||||||
| Address2: | |||||||||
| City: | WENONAH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080902051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122872667 | ||||||||
| FaxNumber: | 8565797734 | ||||||||
| Practice Location | |||||||||
| Address1: | 553 N EVERGREEN AVE | ||||||||
| Address2: | DOCTOR PHYSICAL THERAPY | ||||||||
| City: | WOODBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080961855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565797201 | ||||||||
| FaxNumber: | 8565797734 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2006 | ||||||||
| LastUpdateDate: | 10/10/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT007760L | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251X0800X | 40QA01478500 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.