Individual
MR. SCOTT REYNOLDS
Active
Individual
MR. SCOTT REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
002491
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002491
NY STATE LICENSURE
NY
01
—
2000011183
BOC
—
Enumeration date
09/16/2020
Last updated
09/16/2020
Update your record
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