Provider Demographics
NPI:1861042988
Name:OTTLEY-SCOTT, TAMU
Entity type:Individual
Prefix:
First Name:TAMU
Middle Name:
Last Name:OTTLEY-SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 HEMPSTEAD TPKE STE 130
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2158
Mailing Address - Country:US
Mailing Address - Phone:516-500-5002
Mailing Address - Fax:
Practice Address - Street 1:2571 HEMPSTEAD TPKE STE 130
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2158
Practice Address - Country:US
Practice Address - Phone:516-500-5002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist