Provider Demographics
NPI:1881883551
Name:MICHAEL SCHMIERER DPM LLC
Entity type:Organization
Organization Name:MICHAEL SCHMIERER DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIERER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-360-9200
Mailing Address - Street 1:3 HOSPITAL PLZ
Mailing Address - Street 2:SUITE 314
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3093
Mailing Address - Country:US
Mailing Address - Phone:732-360-9200
Mailing Address - Fax:732-360-2062
Practice Address - Street 1:3 HOSPITAL PLZ
Practice Address - Street 2:SUITE 314
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3093
Practice Address - Country:US
Practice Address - Phone:732-360-9200
Practice Address - Fax:732-360-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00095200213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0667803Medicaid
NY00403356Medicaid
NJ0667803Medicaid
NY00403356Medicaid
NJDE7062Medicare PIN
NJ100028Medicare PIN