Provider Demographics
NPI:1689026429
Name:SCHROEDER, ELIZABETH (MS, CNS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1237
Mailing Address - Country:US
Mailing Address - Phone:856-912-7124
Mailing Address - Fax:
Practice Address - Street 1:208 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1237
Practice Address - Country:US
Practice Address - Phone:856-912-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist