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General NPI Number Information
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NPI Number | 1154283893
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Entity Type | Organization
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Legal Business Name | SCOLI3D, INC.
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 540 BORDENTOWN AVE
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-1546
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Country | US
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Telephone | 646-262-1845
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Fax |
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Provider Business Mailing Address
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Address Line | 141 SILOAM RD
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City | FREEHOLD
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State | NJ
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Zip | 07728-8608
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Country | US
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Telephone | 646-262-1845
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Fax |
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Authorized Official
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Title or Position | CEO - CLINICAL DIRECTOR
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Name | MR. GLENN EASTON
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Credential | CO, LPO, BOCO, BOCP
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Telephone | 646-262-1845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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