Provider Demographics
NPI:1396140406
Name:SCHOENBERG, CLARE FISCHER-DAVIES (PA)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:FISCHER-DAVIES
Last Name:SCHOENBERG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:
Other - Last Name:FISCHER-DAVIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 STRATHMORE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3719
Mailing Address - Country:US
Mailing Address - Phone:401-525-1347
Mailing Address - Fax:
Practice Address - Street 1:1207 CHESTNUT ST FL 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4131
Practice Address - Country:US
Practice Address - Phone:267-725-0252
Practice Address - Fax:215-732-1046
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058320363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical