Provider Demographics
NPI:1639303837
Name:SCHMUKLER, ANITA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:SCHMUKLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BALA AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3212
Mailing Address - Country:US
Mailing Address - Phone:610-617-3155
Mailing Address - Fax:
Practice Address - Street 1:1 BALA AVE
Practice Address - Street 2:STE 212
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3212
Practice Address - Country:US
Practice Address - Phone:610-617-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0028362084P0804X
NJ25MB025403002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry