Healthcare Provider Details

I. General information

NPI: 1811986391
Provider Name (Legal Business Name): SCOTT R STRAUSS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 OLD HIGHWAY 22
CLINTON NJ
08809-1342
US

IV. Provider business mailing address

59 OLD HIGHWAY 22
CLINTON NJ
08809-1342
US

V. Phone/Fax

Practice location:
  • Phone: 908-730-6363
  • Fax: 908-730-8185
Mailing address:
  • Phone: 908-730-6363
  • Fax: 908-730-8185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS010895L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB079990
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: