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General NPI Number Information
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NPI Number | 1770539652
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Entity Type | Individual
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Provider Name | JOHN C. SCHROEDER MD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 55 N GILBERT ST TINTON FALLS VA - CBOC, BLDG 4, STE 4101
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City | TINTON FALLS
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State | NJ
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Zip | 07701-4955
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Country | US
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Telephone | 732-842-4751
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 SWAMP RD # 553
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City | FOUNTAINVILLE
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State | PA
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Zip | 18923-9643
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD038967L
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License Number State | PA
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