Provider Demographics
NPI:1154328748
Name:SCHNALL, BRUCE M (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:M
Last Name:SCHNALL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4406
Mailing Address - Country:US
Mailing Address - Phone:856-772-9090
Mailing Address - Fax:856-772-1460
Practice Address - Street 1:1000 WHITE HORSE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4406
Practice Address - Country:US
Practice Address - Phone:856-772-9090
Practice Address - Fax:856-772-1460
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA05161100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2379201Medicaid
NJ2379201Medicaid
D06896Medicare UPIN