Provider Demographics
NPI:1932112133
Name:SCHNURR, DEBORAH GRACE (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:GRACE
Last Name:SCHNURR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:GRACE
Other - Last Name:PECORA SCHNURR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5 FRANKLIN AVE
Mailing Address - Street 2:STE 410
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109
Mailing Address - Country:US
Mailing Address - Phone:973-751-6610
Mailing Address - Fax:973-759-1155
Practice Address - Street 1:5 FRANKLIN AVE
Practice Address - Street 2:STE 410
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109
Practice Address - Country:US
Practice Address - Phone:973-751-6610
Practice Address - Fax:973-759-1155
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05810700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5410401Medicaid
NJ5410401Medicaid
NJPE506198Medicare ID - Type Unspecified