Healthcare Provider Details

I. General information

NPI: 1114657749
Provider Name (Legal Business Name): MICHELLE SOPHIE SCHECHTER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 TAYLORS MILLS RD
MANALAPAN NJ
07726-3281
US

IV. Provider business mailing address

12 MARSHALL DR
EDISON NJ
08817-2911
US

V. Phone/Fax

Practice location:
  • Phone: 732-462-8412
  • Fax:
Mailing address:
  • Phone: 732-718-2044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00119700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: