Provider Demographics
NPI:1851423842
Name:SCHULD PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SCHULD PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:856-755-3511
Mailing Address - Street 1:455 ROUTE 38 W STE C
Mailing Address - Street 2:
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-2003
Mailing Address - Country:US
Mailing Address - Phone:856-755-3511
Mailing Address - Fax:856-755-3522
Practice Address - Street 1:455 ROUTE 38 W STE C
Practice Address - Street 2:
Practice Address - City:MAPLE SHADE
Practice Address - State:NJ
Practice Address - Zip Code:08052-2003
Practice Address - Country:US
Practice Address - Phone:856-755-3511
Practice Address - Fax:856-755-3522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00970900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ114448Medicare PIN
NJ225100000XMedicare ID - Type UnspecifiedPHYSICAL THERAPIST