Provider Demographics
NPI:1366592974
Name:SCHATZBERG, PETER (DC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:SCHATZBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-1612
Mailing Address - Country:US
Mailing Address - Phone:610-532-0657
Mailing Address - Fax:610-532-4258
Practice Address - Street 1:1308 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-1612
Practice Address - Country:US
Practice Address - Phone:610-532-0657
Practice Address - Fax:610-532-4258
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002552L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0091558000OtherBLUE CROSS
PA901599Medicare ID - Type Unspecified