Healthcare Provider Details

I. General information

NPI: 1104072552
Provider Name (Legal Business Name): MRS. LAURIE E SCHERTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 NEPTUNE BLVD UNIT 12
NEPTUNE NJ
07753-4121
US

IV. Provider business mailing address

444 NEPTUNE BLVD UNIT 12
NEPTUNE NJ
07753-4121
US

V. Phone/Fax

Practice location:
  • Phone: 732-775-1301
  • Fax: 732-775-0507
Mailing address:
  • Phone: 732-775-1301
  • Fax: 732-775-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00012900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: