Provider Demographics
NPI:1720845852
Name:SCHOENFELD, MAXWELL JOSEPH
Entity Type:Individual
Prefix:
First Name:MAXWELL
Middle Name:JOSEPH
Last Name:SCHOENFELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MACK
Other - Middle Name:JOSEPH
Other - Last Name:SCHOENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9 HANCOCK ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2515
Mailing Address - Country:US
Mailing Address - Phone:201-312-5822
Mailing Address - Fax:
Practice Address - Street 1:9 HANCOCK ST APT 1
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-2515
Practice Address - Country:US
Practice Address - Phone:201-312-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2372881163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty