Provider Demographics
NPI:1083801088
Name:GABRIELLE SCHOEPPNER MD
Entity Type:Organization
Organization Name:GABRIELLE SCHOEPPNER MD
Other - Org Name:NORTHWOOD OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOEPPNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-258-7255
Mailing Address - Street 1:3735 NAZARETH RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8338
Mailing Address - Country:US
Mailing Address - Phone:610-258-7255
Mailing Address - Fax:610-258-5197
Practice Address - Street 1:3735 NAZARETH RD
Practice Address - Street 2:SUITE 205
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:610-258-7255
Practice Address - Fax:610-258-5197
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GABRIELLE SCHOEPPNER MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-03
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042419E332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE21995Medicare UPIN
PA1067980001Medicare NSC