1609876044 NPI number — MR. JAMES WILLIAM SCHORSCH III DPT

Table of content: MR. JAMES WILLIAM SCHORSCH III DPT (NPI 1609876044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609876044 NPI number — MR. JAMES WILLIAM SCHORSCH III DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHORSCH
Provider First Name:
JAMES
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
III
Provider Credential Text:
DPT
Provider Gender Code:
M

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:
1609876044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 KITTY KNIGHT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHURCHVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18966-1130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-364-1151
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 FRANKLIN CORNER RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08648-2526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-896-9054
Provider Business Practice Location Address Fax Number:
609-896-9059
Provider Enumeration Date:
07/28/2005

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: 225100000X , with the licence number:  40QA00537800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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