Healthcare Provider Details

I. General information

NPI: 1982949335
Provider Name (Legal Business Name): SHELLEY A SCHWARTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 QUALITY WAY
ISELIN NJ
08830-2924
US

IV. Provider business mailing address

1 MARTIN AVE
CHERRY HILL NJ
08002-2628
US

V. Phone/Fax

Practice location:
  • Phone: 732-726-0327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number25MG00108300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: