Healthcare Provider Details

I. General information

NPI: 1003875980
Provider Name (Legal Business Name): GABRIELLE SCHOEPPNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 06/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 NAZARETH RD SUITE 205
EASTON PA
18045-8338
US

IV. Provider business mailing address

3735 NAZARETH RD SUITE 205
EASTON PA
18045-8338
US

V. Phone/Fax

Practice location:
  • Phone: 610-258-7255
  • Fax: 610-258-5197
Mailing address:
  • Phone: 610-258-7255
  • Fax: 610-258-5197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD042419E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberMD042419E
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD042419E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: