Healthcare Provider Details

I. General information

NPI: 1215923388
Provider Name (Legal Business Name): STUART JOEL SCHNELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST CCP-9
BRIGHTON MA
02135-2907
US

IV. Provider business mailing address

736 CAMBRIDGE STREET BONE & JOINT CENTER, CCP-9
BRIGHTON MA
02135
US

V. Phone/Fax

Practice location:
  • Phone: 617-787-5111
  • Fax: 617-787-5150
Mailing address:
  • Phone: 617-787-5111
  • Fax: 617-787-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number41617
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: