Provider Demographics
NPI:1528539525
Name:SCHOENBERGER, DAVID R (PSYA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:SCHOENBERGER
Suffix:
Gender:M
Credentials:PSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MAIN ST APT 10G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-8216
Mailing Address - Country:US
Mailing Address - Phone:917-822-9449
Mailing Address - Fax:
Practice Address - Street 1:27 WEST 12TH STREET
Practice Address - Street 2:APT 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014
Practice Address - Country:US
Practice Address - Phone:917-822-9449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001039102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst