MEDICARE: SCOTT PHYSICAL THERAPY P.C.

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	225100000X	Physical Therapist	013940-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20370P	OTHER	NY	HIP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841270923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT PHYSICAL THERAPY P.C.

Provider Business Mailing Address
First Line	:	1514 VOORHIES AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NEW YORK
Zip	:	11235
Country	:	UM
Telephone Number	:	718-648-0888
Fax Number	:	718-648-0411

Provider Business Practice Location Address
First Line	:	413 86TH ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4707
Country	:	US
Telephone Number	:	718-921-9721
Fax Number	:	718-921-9349

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARK EHUD AMIR
Credential	:	PT
Telephone Number	:	718-648-0888

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	09/26/2008

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