1851531958 NPI number — DR. JOANNE M. SCHROEDER PSY.D.

Table of content: DR. JOANNE M. SCHROEDER PSY.D. (NPI 1851531958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851531958 NPI number — DR. JOANNE M. SCHROEDER PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHROEDER
Provider First Name:
JOANNE
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851531958
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 224
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENNSVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08070-0224
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-348-7180
Provider Business Mailing Address Fax Number:
610-891-7827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1138 E CHESTNUT AVE
Provider Second Line Business Practice Location Address:
BLDG. 6B
Provider Business Practice Location Address City Name:
VINELAND
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08360-5053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-348-7180
Provider Business Practice Location Address Fax Number:
610-891-7827
Provider Enumeration Date:
03/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  35SI00402100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: PS008954L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X , with the licence number: PS008954L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)