Provider Demographics
NPI:1144413311
Name:SCHWAB, MARCI (AUD)
Entity Type:Individual
Prefix:MRS
First Name:MARCI
Middle Name:
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:800-328-8602
Mailing Address - Fax:
Practice Address - Street 1:241 FORSGATE DR
Practice Address - Street 2:SUITE 112
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1385
Practice Address - Country:US
Practice Address - Phone:732-656-7701
Practice Address - Fax:732-656-7703
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ237600000X
NJ25MG00121000237700000X
NJ41YA00062500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ236295ZDHSOtherMEDICARE