MEDICARE: JONATHAN SCOT SCHREIBER 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	208200000X	Plastic Surgery Physician	034529	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528065984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN SCOT SCHREIBER M.D.

Provider Business Mailing Address
First Line	:	1 BARNARD LANE
Second Line	:	SUITE 102
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002
Country	:	US
Telephone Number	:	860-243-1889
Fax Number	:	860-243-5733

Provider Business Practice Location Address
First Line	:	1 BARNARD LANE
Second Line	:	SUITE 102
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002
Country	:	US
Telephone Number	:	860-243-1889
Fax Number	:	860-243-5733

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	01/09/2012

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