Healthcare Provider Details

I. General information

NPI: 1669525879
Provider Name (Legal Business Name): SCOTT OGREN PT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 BEDFORD RD
ARMONK NY
10504-1937
US

IV. Provider business mailing address

15 LOVELY LN
CARMEL NY
10512-4311
US

V. Phone/Fax

Practice location:
  • Phone: 845-661-0177
  • Fax:
Mailing address:
  • Phone: 845-276-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number018722
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: