Provider Demographics
NPI:1578538039
Name:SCHENK, RICHARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:SCHENK
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 1:91 S JEFFERSON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1029
Mailing Address - Country:US
Mailing Address - Phone:973-599-9779
Mailing Address - Fax:973-599-1179
Practice Address - Street 1:91 S JEFFERSON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1029
Practice Address - Country:US
Practice Address - Phone:973-599-9779
Practice Address - Fax:973-599-1179
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD462817207X00000X
NJ25MA04658900207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ200421776OtherTIN
NJ084094Medicare ID - Type Unspecified