Healthcare Provider Details

I. General information

NPI: 1538461306
Provider Name (Legal Business Name): CLINTON JAMES SCHLENKER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 DONALD ROSS RD STE 200
PALM BEACH GARDENS FL
33418-5105
US

IV. Provider business mailing address

140 BOULEVARD
WASHINGTON NJ
07882-1761
US

V. Phone/Fax

Practice location:
  • Phone: 561-624-4509
  • Fax: 561-624-0393
Mailing address:
  • Phone: 908-689-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB09373900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS15111
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: