Provider Demographics
NPI:1437159902
Name:SCHALET, BENNETT D (DO)
Entity Type:Individual
Prefix:DR
First Name:BENNETT
Middle Name:D
Last Name:SCHALET
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 MADISON AVE
Practice Address - Street 2:SUITE B01
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6092
Practice Address - Country:US
Practice Address - Phone:973-898-1220
Practice Address - Fax:973-898-1496
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05264200207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6556604Medicaid
NJ8459606Medicaid
NJF79384Medicare UPIN
NJ025081Medicare ID - Type Unspecified
NJ120760M4NMedicare ID - Type Unspecified