1396140406 NPI number — CLARE FISCHER-DAVIES SCHOENBERG PA

Table of content: CLARE FISCHER-DAVIES SCHOENBERG PA (NPI 1396140406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396140406 NPI number — CLARE FISCHER-DAVIES SCHOENBERG PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHOENBERG
Provider First Name:
CLARE
Provider Middle Name:
FISCHER-DAVIES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FISCHER-DAVIES
Provider Other First Name:
CLARE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396140406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 STRATHMORE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAVERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19083-3719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-525-1347
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1207 CHESTNUT ST FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-4131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-725-0252
Provider Business Practice Location Address Fax Number:
215-732-1046
Provider Enumeration Date:
10/31/2014

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: 363AM0700X , with the licence number:  MA058320 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com