1558403410 NPI number — MICHAEL A. SCHENKER PHD INC

Table of content: (NPI 1558403410)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558403410 NPI number — MICHAEL A. SCHENKER PHD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL A. SCHENKER PHD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1558403410
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
402 NW 152ND LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEMBROKE PINES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33028-1844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-547-3086
Provider Business Mailing Address Fax Number:
954-827-0711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 N HIATUS RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
PEMBROKE PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33026-3097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-547-3086
Provider Business Practice Location Address Fax Number:
954-827-0711
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHENKER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-547-3086

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PY5906 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9413593 . This is a "PHCS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 302125 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com