Healthcare Provider Details

I. General information

NPI: 1902314891
Provider Name (Legal Business Name): ETYA SCHECTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2018
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 ROUTE 70 E
CHERRY HILL NJ
08034-2240
US

IV. Provider business mailing address

P O BOX 7776
LANCASTER PA
17601
US

V. Phone/Fax

Practice location:
  • Phone: 888-985-2727
  • Fax:
Mailing address:
  • Phone: 888-985-2727
  • Fax: 856-779-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00461700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: