MEDICARE: DR. JASON MARC SCHOENFELD 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	207N00000X	Dermatology Physician	MD460432	PA
2	207ND0101X	MOHS-Micrographic Surgery Physician	MD460432	PA
3	207ND0101X	MOHS-Micrographic Surgery Physician	25MA11001800	NJ

General Provider Information

NPI Number	:	1942647078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON MARC SCHOENFELD M.D.

Provider Business Mailing Address
First Line	:	713 WALTON CT
Second Line	:
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-3739
Country	:	US
Telephone Number	:	516-205-0501
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 ROOSEVELT BLVD STE 506
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-1030
Country	:	US
Telephone Number	:	610-288-2908
Fax Number	:	610-898-4832

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

Provider Enumeration Date	:	05/30/2013
Last Update Date	:	04/15/2021

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