Healthcare Provider Details
I. General information
NPI: 1477245082
Provider Name (Legal Business Name): CC THERAPY GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2023
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 PALISADE ST STE 200
DOBBS FERRY NY
10522-1627
US
IV. Provider business mailing address
145 PALISADE ST STE 200
DOBBS FERRY NY
10522-1627
US
V. Phone/Fax
- Phone: 617-302-6244
- Fax: 617-915-3196
- Phone: 617-302-6244
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0008X |
| Taxonomy | Pediatric Neurodevelopmental Disabilities Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
DOMINIC
SCAHILL
Title or Position: PRESIDENT
Credential: MD
Phone: 510-871-5025