Provider Demographics
NPI:1265419634
Name:SCHRAM, ADRIANN S (MD)
Entity type:Individual
Prefix:
First Name:ADRIANN
Middle Name:S
Last Name:SCHRAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADRIANN
Other - Middle Name:S
Other - Last Name:GOMBAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:579A CRANBURY RD
Mailing Address - Street 2:UNIVERSITY RADIOLOGY GROUP PC
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-390-0040
Mailing Address - Fax:732-390-1856
Practice Address - Street 1:483 CRANBURY RD
Practice Address - Street 2:UNIVERSITY RADIOLOGY GROUP PC
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3610
Practice Address - Country:US
Practice Address - Phone:732-390-0030
Practice Address - Fax:732-390-1856
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA076248002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02664280Medicaid
NJ0072419Medicaid
NY02664280Medicaid
I30968Medicare UPIN