Basic Information
| Provider Information | |||||||||
| NPI: | 1033160445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHREIBER | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | FELICE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10415 EWELL AVE | ||||||||
| Address2: | |||||||||
| City: | KENSINGTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208954028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015308426 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2115 WISCONSIN AVE NW | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200072265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2029445400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 05/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 150868 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 3151301 | 05 | MA | MEDICAID |