Provider Demographics
NPI:1891861258
Name:HERSHON SCHNEIDER, ROBERTA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:
Last Name:HERSHON SCHNEIDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 PLEASANT VALLEY WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1426
Mailing Address - Country:US
Mailing Address - Phone:973-243-8860
Mailing Address - Fax:973-243-8863
Practice Address - Street 1:1001 PLEASANT VALLEY WAY STE 4
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1426
Practice Address - Country:US
Practice Address - Phone:973-243-8860
Practice Address - Fax:973-243-8863
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00091700237600000X
NJ41YA00045100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0066303Medicaid
NJ082119Medicare ID - Type Unspecified