Healthcare Provider Details

I. General information

NPI: 1841514510
Provider Name (Legal Business Name): HENRY G SCHRIEVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SANDY COVE LN
BEACH HAVEN NJ
08008-6154
US

IV. Provider business mailing address

9 SANDY COVE LN
BEACH HAVEN NJ
08008-6154
US

V. Phone/Fax

Practice location:
  • Phone: 609-361-0217
  • Fax: 609-361-0217
Mailing address:
  • Phone: 609-361-0217
  • Fax: 609-361-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number25MAO01917900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: