Healthcare Provider Details

I. General information

NPI: 1639303837
Provider Name (Legal Business Name): ANITA SCHMUKLER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BALA AVE STE 212
BALA CYNWYD PA
19004-3212
US

IV. Provider business mailing address

1 BALA AVE SUITE 212
BALA CYNWYD PA
19004-3212
US

V. Phone/Fax

Practice location:
  • Phone: 610-617-3155
  • Fax:
Mailing address:
  • Phone: 610-617-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberOS002836
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MB02540300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: