MEDICARE: THOMAS SCHUMANN VATES 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	2088P0231X	Pediatric Urology Physician	25MA05647700	NJ

General Provider Information

NPI Number	:	1447258637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS SCHUMANN VATES M.D.

Provider Business Mailing Address
First Line	:	557 CRANBURY RD
Second Line	:	STE 4
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-5419
Country	:	US
Telephone Number	:	732-613-9144
Fax Number	:	732-613-5121

Provider Business Practice Location Address
First Line	:	557 CRANBURY RD
Second Line	:	STE 4
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-5419
Country	:	US
Telephone Number	:	732-613-9144
Fax Number	:	732-613-5121

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	06/12/2012

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