Provider Demographics
NPI:1912294620
Name:SCHENKEL, KRISTA MARIE (D,O)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:MARIE
Last Name:SCHENKEL
Suffix:
Gender:F
Credentials:D,O
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:MARIE
Other - Last Name:PUMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-488-7080
Mailing Address - Fax:610-488-7019
Practice Address - Street 1:44 EAST AVENUE
Practice Address - Street 2:
Practice Address - City:STRAUSSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19559-0470
Practice Address - Country:US
Practice Address - Phone:610-488-7080
Practice Address - Fax:610-488-7019
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016492207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine