Provider Demographics
NPI:1750327326
Name:SCHENKER, SAMUEL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:DAVID
Last Name:SCHENKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-9621
Mailing Address - Country:US
Mailing Address - Phone:732-814-3745
Mailing Address - Fax:
Practice Address - Street 1:285 PARKER RD
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-9621
Practice Address - Country:US
Practice Address - Phone:732-814-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04118800207RG0300X, 208VP0000X, 2084P2900X
NJMA41188174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
433628Medicare ID - Type Unspecified
NJC54908Medicare UPIN