Provider Demographics
NPI:1639337884
Name:SCHNEIDKRAUT, JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:SCHNEIDKRAUT
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 1:342 HAMBURG TPKE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2162
Mailing Address - Country:US
Mailing Address - Phone:973-513-9646
Mailing Address - Fax:973-513-9644
Practice Address - Street 1:342 HAMBURG TPKE
Practice Address - Street 2:SUITE 209
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2162
Practice Address - Country:US
Practice Address - Phone:973-513-9646
Practice Address - Fax:973-513-9644
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60216210207XX0801X
NJ25MA08474200207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1639337884Medicaid
WA8901587Medicare PIN