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NPI 1073622684

NPI 1073622684 : SCOTT M RABOY DPM : CLIFTON, NJ

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General NPI Number Information
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    NPI Number           |    1073622684
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT M RABOY DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/29/2006
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    Last Update Date     |    01/03/2013
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Provider Practice Location Address
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    Address Line         |    1081 PAULISON AVE 
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    City                 |    CLIFTON
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    State                |    NJ
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    Zip                  |    07011-3627
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    Country              |    US
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    Telephone            |    973-340-1400
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    Fax                  |    973-340-7470
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Provider Business Mailing Address
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    Address Line         |    1081 PAULISON AVE 
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    City                 |    CLIFTON
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    State                |    NJ
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    Zip                  |    07011-3627
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    Country              |    US
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    Telephone            |    973-340-1400
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    Fax                  |    973-340-7470
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    25MD00188500
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    License Number State |    NJ
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