Provider Demographics
NPI:1003892373
Name:SCHNEIDERMAN, MARK I (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:I
Last Name:SCHNEIDERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WALTER FORAN BLVD
Mailing Address - Street 2:STE 304
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4664
Mailing Address - Country:US
Mailing Address - Phone:908-788-3624
Mailing Address - Fax:908-788-2675
Practice Address - Street 1:4 WALTER FORAN BLVD
Practice Address - Street 2:STE 304
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4664
Practice Address - Country:US
Practice Address - Phone:908-788-3624
Practice Address - Fax:908-788-2675
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00178900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP413714OtherOXFORD INS CO
NJP413714OtherOXFORD INS CO