Healthcare Provider Details

I. General information

NPI: 1629057757
Provider Name (Legal Business Name): ROBERT SCHNITZLEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3186 STATE ROUTE 27 SUITE 204
KENDALL PARK NJ
08824-1513
US

IV. Provider business mailing address

2953 AIRDRIE AVE
ABINGDON MD
21009-2422
US

V. Phone/Fax

Practice location:
  • Phone: 732-940-6117
  • Fax: 443-512-0644
Mailing address:
  • Phone: 732-778-3672
  • Fax: 443-512-0644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0062487
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: