Healthcare Provider Details

I. General information

NPI: 1295727121
Provider Name (Legal Business Name): TODD SCHACHTER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 E LAUREL RD STE 2100-A
STRATFORD NJ
08084-1354
US

IV. Provider business mailing address

42 E LAUREL RD STE 2100-A
STRATFORD NJ
08084-1354
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-7020
  • Fax: 856-566-6188
Mailing address:
  • Phone: 856-566-7020
  • Fax: 856-566-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB04654200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number25MB04654200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: