Basic Information
| Provider Information | |||||||||
| NPI: | 1205169620 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHENKER | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 191 | ||||||||
| Address2: | PROVIDER ENROLLMENT DEPT | ||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197320191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026516212 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 ROCKLAND ROAD | ||||||||
| Address2: | |||||||||
| City: | DELAWARE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198033602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026514641 | ||||||||
| FaxNumber: | 3026514476 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2009 | ||||||||
| LastUpdateDate: | 02/28/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085P0229X | 25MA099749200 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | 2085R0202X | MT195512 | PA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085P0229X | ME128778 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | 2085P0229X | C10011796 | DE | Y | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology |
No ID Information.