1437476124 NPI number — MS. REBECCA NANCY SCHOENEWOLF

Table of content: MS. REBECCA NANCY SCHOENEWOLF (NPI 1437476124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437476124 NPI number — MS. REBECCA NANCY SCHOENEWOLF

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHOENEWOLF
Provider First Name:
REBECCA
Provider Middle Name:
NANCY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOLEY
Provider Other First Name:
NANCY
Provider Other Middle Name:
SCHOENEWOLF
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437476124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
152 DEER HILL AVE
Provider Second Line Business Mailing Address:
STE. 119
Provider Business Mailing Address City Name:
DANBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-573-5440
Provider Business Mailing Address Fax Number:
203-748-0100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
152 DEER HILL AVE
Provider Second Line Business Practice Location Address:
STE. 119
Provider Business Practice Location Address City Name:
DANBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-573-5440
Provider Business Practice Location Address Fax Number:
203-748-0100
Provider Enumeration Date:
04/21/2010

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 7622 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 2775 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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