Provider Demographics
NPI:1962707828
Name:STRUBINGER, SCOTT EDWARD (RD)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EDWARD
Last Name:STRUBINGER
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18
Mailing Address - Street 2:
Mailing Address - City:LENNI
Mailing Address - State:PA
Mailing Address - Zip Code:19052
Mailing Address - Country:US
Mailing Address - Phone:484-574-9217
Mailing Address - Fax:
Practice Address - Street 1:2600 W 9TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:484-574-9217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OH725201133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered