1750596524 NPI number — PETER SCHATZBERG, D.C.

Table of content: (NPI 1750596524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750596524 NPI number — PETER SCHATZBERG, D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER SCHATZBERG, D.C.
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:
6
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:
1750596524
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1726 S BROAD ST FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19145-2300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-551-3720
Provider Business Mailing Address Fax Number:
215-551-3958

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1308 MACDADE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOLSOM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19033-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-532-0657
Provider Business Practice Location Address Fax Number:
610-532-4258
Provider Enumeration Date:
05/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHATZBERG
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
215-551-3720

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2857187000 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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