Basic Information
Provider Information | |||||||||
NPI: | 1023114592 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SCHNUR | ||||||||
FirstName: | RHONDA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3 COOPER PLZ | ||||||||
Address2: | SUITE 502 | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031438 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8569636888 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 3 COOPER PLZ | ||||||||
Address2: | SUITE 200 | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031438 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563422001 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/15/2006 | ||||||||
LastUpdateDate: | 04/25/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MA63463 | NJ | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 207SG0201X | MA63463 | NJ | Y |   | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) |
ID Information
ID | Type | State | Issuer | Description | 0194416000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | CA0000018 | 01 | NJ | AMERICHOICE | OTHER | 0549207 | 05 | NJ |   | MEDICAID | 1043514 | 01 | NJ | HORIZON NJ HEALTH | OTHER | P1870435 | 01 | NJ | OXFORD | OTHER | 1422979 | 01 | NJ | UNITED HEALTHCARE | OTHER | 2969179 | 01 | NJ | AETNA | OTHER | 3209174 | 01 | NJ | CIGNA | OTHER | 3K5971 | 01 | NJ | HEALTHNET, INC | OTHER | 23326 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 472969 | 01 | NJ | AMERIHEALTH PPO/ PA BS | OTHER |