Basic Information
Provider Information
NPI: 1043410038
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOENFELD
FirstName: ANDREW
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 75 FRANCIS ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 9157421833
FaxNumber: 9157421931
Practice Location
Address1: 75 FRANCIS ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 9157421833
FaxNumber: 9157421931
Other Information
ProviderEnumerationDate: 07/19/2007
LastUpdateDate: 11/10/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X234669MAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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