Provider Demographics
NPI:1558403410
Name:MICHAEL A. SCHENKER PHD INC
Entity Type:Organization
Organization Name:MICHAEL A. SCHENKER PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHENKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-547-3086
Mailing Address - Street 1:402 NW 152ND LN
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1844
Mailing Address - Country:US
Mailing Address - Phone:954-547-3086
Mailing Address - Fax:954-827-0711
Practice Address - Street 1:1000 N HIATUS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3097
Practice Address - Country:US
Practice Address - Phone:954-547-3086
Practice Address - Fax:954-827-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5906103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9413593OtherPHCS
FL302125OtherAVMED