Healthcare Provider Details

I. General information

NPI: 1629987201
Provider Name (Legal Business Name): SCOTT DAVIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ROUTE 9 UNIT B1
WARETOWN NJ
08758-1767
US

IV. Provider business mailing address

500 ROUTE 9 UNIT B1
WARETOWN NJ
08758-1767
US

V. Phone/Fax

Practice location:
  • Phone: 609-488-1878
  • Fax: 866-842-7430
Mailing address:
  • Phone: 609-488-1878
  • Fax: 866-842-7430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02446800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: