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General NPI Number Information
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NPI Number | 1609743459
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Entity Type | Individual
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Provider Name | SCOTT PATRICK EBNER PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 18 E LAUREL RD
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City | STRATFORD
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State | NJ
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Zip | 08084-1327
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Country | US
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Telephone | 856-346-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 107 CEDAR RD
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City | PITTSGROVE
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State | NJ
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Zip | 08318-3830
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Country | US
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Telephone | 856-625-0263
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00980500
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License Number State | NJ
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