Provider Demographics
NPI:1720279276
Name:PAUL H SCHENCK MD PC
Entity Type:Organization
Organization Name:PAUL H SCHENCK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHENCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:610-398-2800
Mailing Address - Street 1:5239 HAMILTON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9153
Mailing Address - Country:US
Mailing Address - Phone:610-398-2800
Mailing Address - Fax:610-366-1343
Practice Address - Street 1:5239 HAMILTON BOULEVARD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9153
Practice Address - Country:US
Practice Address - Phone:610-398-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAUL H SCHENCK MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-08
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017334E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
126703Medicare PIN