Provider Demographics
NPI:1538129929
Name:SCHOENBERG, ERIC (PT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SCHOENBERG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIKE CIR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-5611
Mailing Address - Country:US
Mailing Address - Phone:508-740-5229
Mailing Address - Fax:
Practice Address - Street 1:5 MIKE CIR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-5611
Practice Address - Country:US
Practice Address - Phone:508-740-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0332577Medicaid
MAY68682Medicare PIN