Provider Demographics
NPI:1295972602
Name:ANDREW SCHMIERER DPM PODIATRIST, LLC
Entity type:Organization
Organization Name:ANDREW SCHMIERER DPM PODIATRIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMIERER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-860-9111
Mailing Address - Street 1:18 CENTRE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1501
Mailing Address - Country:US
Mailing Address - Phone:609-860-9111
Mailing Address - Fax:609-860-9311
Practice Address - Street 1:18 CENTRE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1501
Practice Address - Country:US
Practice Address - Phone:609-860-9111
Practice Address - Fax:609-860-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00270700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0011665Medicaid
160436Medicare PIN
NJU94811Medicare UPIN
NJ0011665Medicaid