Provider Demographics
NPI:1871096610
Name:ROVITO, SCOTT (NP)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:ROVITO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PEHLE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5836
Mailing Address - Country:US
Mailing Address - Phone:480-862-1706
Mailing Address - Fax:
Practice Address - Street 1:350 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1348
Practice Address - Country:US
Practice Address - Phone:267-292-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00764700363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care