Provider Demographics
NPI:1114002722
Name:SCHREIBER, MARTHA LINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:LINDA
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7828
Mailing Address - Country:US
Mailing Address - Phone:732-922-0751
Mailing Address - Fax:
Practice Address - Street 1:1540 STATE ROUTE 138
Practice Address - Street 2:
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719-3763
Practice Address - Country:US
Practice Address - Phone:732-280-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA034947208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C59083Medicare UPIN
069199A41Medicare ID - Type Unspecified