Provider Demographics
NPI:1205997004
Name:SCOTTO, BETTY JEAN (MSPT)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:SCOTTO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:JEAN
Other - Last Name:POULOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1242 CHINQUAPIN MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-4582
Mailing Address - Country:US
Mailing Address - Phone:631-987-4749
Mailing Address - Fax:
Practice Address - Street 1:1242 CHINQUAPIN MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-4582
Practice Address - Country:US
Practice Address - Phone:631-987-4749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ70681OtherBLUE CROSS BLUE SHIELD
NY1205997004OtherNPI
NYQ6BM2KW671Medicare PIN