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NPI Code Detail

MEDICARE: DR. SCOTT JOSEPH KONINGSWOOD PT, DPT

MEDICARE: DR. SCOTT JOSEPH KONINGSWOOD PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA01907700NJ

General Provider Information

NPI Number : 1023655016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT JOSEPH KONINGSWOOD PT, DPT
Provider Business Mailing Address
First Line : 41 MOUNTAIN AVE
Second Line :
City : HAWTHORNE
State : NJ
Zip : 07506-3331
Country : US
Telephone Number : 973-513-2120
Fax Number :
Provider Business Practice Location Address
First Line : 321 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2120
Country : US
Telephone Number : 862-203-1570
Fax Number : 862-229-9770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2019
Last Update Date : 05/15/2026

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