Provider Demographics
NPI:1497024293
Name:SCHESCHUK, DANIELLE MARIA (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIA
Last Name:SCHESCHUK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIA
Other - Last Name:FORTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2950 COLLEGE DR
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6933
Mailing Address - Country:US
Mailing Address - Phone:856-362-8898
Mailing Address - Fax:856-362-8903
Practice Address - Street 1:2950 COLLEGE DR
Practice Address - Street 2:SUITE 1B
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6933
Practice Address - Country:US
Practice Address - Phone:856-362-8898
Practice Address - Fax:856-362-8903
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00273200208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery