Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 114864 | NY |
NPI | 1811974785 |
---|---|
Provider Name | Dr. Morris Jacob Schoeneman |
First Address | Mamaroneck, NY 10543 |
Second Address | Brooklyn, NY 11203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 03/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B80176 | (02) |