Provider Demographics
NPI:1831249622
Name:FARMINGDALE FAMILY PRACTICE ASSOCIATES LLC
Entity type:Organization
Organization Name:FARMINGDALE FAMILY PRACTICE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHAUER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:732-938-6471
Mailing Address - Street 1:43 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-1326
Mailing Address - Country:US
Mailing Address - Phone:732-938-6471
Mailing Address - Fax:732-938-3563
Practice Address - Street 1:43 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07727-1326
Practice Address - Country:US
Practice Address - Phone:732-938-6471
Practice Address - Fax:732-938-3563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8460701Medicaid
NJ042421Medicare ID - Type UnspecifiedGROUP #