Basic Information
| Provider Information | |||||||||
| NPI: | 1659753770 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHUSTER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HYGEIA DR | ||||||||
| Address2: | SUITE 2300 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026237156 | ||||||||
| FaxNumber: | 3026230394 | ||||||||
| Practice Location | |||||||||
| Address1: | 3506 KENNETT PIKE | ||||||||
| Address2: | PMRI | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198073019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026613043 | ||||||||
| FaxNumber: | 3026613010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2015 | ||||||||
| LastUpdateDate: | 06/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | DE | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.