Provider Demographics
NPI:1366713216
Name:HOAGLAND, SCOTT DAMIAN (ATC,LAT,MS)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAMIAN
Last Name:HOAGLAND
Suffix:
Gender:M
Credentials:ATC,LAT,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 KINGSBURY CT
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-1121
Mailing Address - Country:US
Mailing Address - Phone:610-746-6468
Mailing Address - Fax:
Practice Address - Street 1:268 S FINLEY AVE
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1435
Practice Address - Country:US
Practice Address - Phone:908-204-2585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000775002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer