Healthcare Provider Details

I. General information

NPI: 1003772690
Provider Name (Legal Business Name): CC THERAPY MEDICAL GROUP OF NJ, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
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

Practice location:
  • Phone: 240-426-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCAHILL
Title or Position: PRESIDENT
Credential: MD
Phone: 240-426-7400