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NPI Code Detail

MEDICARE: MR. MARK SCHEIDT PT

MEDICARE: MR. MARK SCHEIDT PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA00970400NJ

General Provider Information

NPI Number : 1205897741
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK SCHEIDT PT
Provider Business Mailing Address
First Line : 30 EVERGREEN LN
Second Line :
City : HADDONFIELD
State : NJ
Zip : 08033-1202
Country : US
Telephone Number : 856-429-9148
Fax Number :
Provider Business Practice Location Address
First Line : 132 W MAIN ST
Second Line :
City : MOORESTOWN
State : NJ
Zip : 08057-2432
Country : US
Telephone Number : 856-234-4397
Fax Number : 856-234-6653
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 07/08/2007

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