=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962739177
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORBERT SCHACHTER MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2009
-----------------------------------------------------
Last Update Date | 11/09/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 547 VALLEY RD
-----------------------------------------------------
City | MONTCLAIR
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07043-1880
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-783-6446
-----------------------------------------------------
Fax | 973-783-6448
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 547 VALLEY RD
-----------------------------------------------------
City | MONTCLAIR
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07043-1880
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-783-6446
-----------------------------------------------------
Fax | 973-783-6448
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL BILLER
-----------------------------------------------------
Name | MARIA ARIAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-879-7297
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 25MA03140300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------