MEDICARE: KENNETH DAVID SCHULNER M.D.

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
1	207RC0000X	Cardiovascular Disease Physician	25MA04240900	NJ

General Provider Information

NPI Number	:	1417900614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH DAVID SCHULNER M.D.

Provider Business Mailing Address
First Line	:	220 SUNSET RD
Second Line	:	STE 2B
City	:	WILLINGBORO
State	:	NJ
Zip	:	08046-1126
Country	:	US
Telephone Number	:	609-871-4487
Fax Number	:	609-871-4491

Provider Business Practice Location Address
First Line	:	220 SUNSET RD
Second Line	:	STE 2B
City	:	WILLINGBORO
State	:	NJ
Zip	:	08046-1126
Country	:	US
Telephone Number	:	609-871-4487
Fax Number	:	609-871-4491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/09/2007

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