Provider Demographics
NPI:1033247036
Name:SCHROEDER, RONALD E (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:E
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1326
Mailing Address - Country:US
Mailing Address - Phone:908-735-7011
Mailing Address - Fax:
Practice Address - Street 1:21 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1326
Practice Address - Country:US
Practice Address - Phone:908-735-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSC716510Medicare ID - Type Unspecified