Provider Demographics
NPI:1245638865
Name:SCHOENBORN, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:SCHOENBORN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 GIORDANO LN
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-8420
Mailing Address - Country:US
Mailing Address - Phone:609-567-3572
Mailing Address - Fax:
Practice Address - Street 1:144 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2141
Practice Address - Country:US
Practice Address - Phone:609-465-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01585800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist