MEDICARE: MR. SCOTT OGREN PT, CSCS

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
1	2251X0800X	Orthopedic Physical Therapist	018722	NY

General Provider Information

NPI Number	:	1669525879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT OGREN PT, CSCS

Provider Business Mailing Address
First Line	:	15 LOVELY LN
Second Line	:
City	:	CARMEL
State	:	NY
Zip	:	10512-4311
Country	:	US
Telephone Number	:	845-276-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 BEDFORD RD
Second Line	:
City	:	ARMONK
State	:	NY
Zip	:	10504-1937
Country	:	US
Telephone Number	:	845-661-0177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	06/25/2013

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