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General NPI Number Information
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NPI Number | 1235953522
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Entity Type | Individual
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Provider Name | MATTHIAS A SCOTT LMT, MMP, COMT
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Gender | Male
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 70 OUTWATER LN 2ND FL
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City | GARFIELD
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State | NJ
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Zip | 07026-3854
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Country | US
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Telephone | 844-371-1125
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Fax |
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Provider Business Mailing Address
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Address Line | 11 LLOYD CT APT 2B
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City | NUTLEY
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State | NJ
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Zip | 07110-2367
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Country | US
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Telephone | 973-931-5803
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT00839000
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License Number State | NJ
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