Provider Demographics
NPI:1275640187
Name:SCHMIDT, ALVIN MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:MANUEL
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:85 S JEFFERSON ST
Mailing Address - Street 2:STE. 1
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-1562
Mailing Address - Country:US
Mailing Address - Phone:973-677-3466
Mailing Address - Fax:973-677-2362
Practice Address - Street 1:741 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1174
Practice Address - Country:US
Practice Address - Phone:973-325-1004
Practice Address - Fax:973-736-8964
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03805500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1K9717OtherHEALTHNET
NYAS057A3610OtherBCBS
NJ1283006Medicaid
451037P33Medicare PIN
C55159Medicare UPIN