Provider Demographics
NPI:1477560985
Name:SCHNECK, PAUL E (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:E
Last Name:SCHNECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 ENGLE ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2530
Mailing Address - Country:US
Mailing Address - Phone:201-568-0505
Mailing Address - Fax:201-871-0031
Practice Address - Street 1:163 ENGLE ST STE 1A
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2530
Practice Address - Country:US
Practice Address - Phone:201-568-0505
Practice Address - Fax:201-871-0031
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0252282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY082718OtherMEDICAL LICENSE
NJ25MA025228OtherMEDICAL LICENSE
NJ449712BHDMedicare PIN
NJ25MA025228OtherMEDICAL LICENSE
NJ526357Medicare PIN
NJ449712Medicare PIN