Provider Demographics
NPI:1114373172
Name:SCHNECK, DARLENE MARIE
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:MARIE
Last Name:SCHNECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2011
Mailing Address - Country:US
Mailing Address - Phone:856-361-1100
Mailing Address - Fax:
Practice Address - Street 1:2500 MCCLELLAN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4613
Practice Address - Country:US
Practice Address - Phone:856-361-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06836000164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse