Provider Demographics
NPI:1871582304
Name:DRUCKMAN, SCOTT J (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:DRUCKMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:27 S. COOKS BRIDGE RD.
Mailing Address - Street 2:STE 2-1
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2524
Mailing Address - Country:US
Mailing Address - Phone:732-987-5780
Mailing Address - Fax:732-987-5787
Practice Address - Street 1:27 S COOKS BRIDGE RD
Practice Address - Street 2:SUITE 2-1
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2524
Practice Address - Country:US
Practice Address - Phone:732-367-0166
Practice Address - Fax:732-367-7220
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB062859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000255WNCMedicare PIN
NJG56638Medicare UPIN