Provider Demographics
NPI:1821428376
Name:206-208 NORTH UNION STREET LLC
Entity Type:Organization
Organization Name:206-208 NORTH UNION STREET LLC
Other - Org Name:PETER SCHATZBERG, D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COLLECTIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'TOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-575-1145
Mailing Address - Street 1:1308 MACDADE BLVD
Mailing Address - Street 2:P.O. BOX 407
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-1612
Mailing Address - Country:US
Mailing Address - Phone:610-532-0657
Mailing Address - Fax:610-870-0325
Practice Address - Street 1:1308 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-1612
Practice Address - Country:US
Practice Address - Phone:610-532-0657
Practice Address - Fax:610-870-0325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000800111N00000X
DEF1-0000776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty