Provider Demographics
NPI:1073923603
Name:REED-SCHRADER, ESSIE
Entity type:Individual
Prefix:
First Name:ESSIE
Middle Name:
Last Name:REED-SCHRADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ST LUKES LN
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-6217
Mailing Address - Country:US
Mailing Address - Phone:272-212-1000
Mailing Address - Fax:272-212-0201
Practice Address - Street 1:100 ST LUKES LN
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-6217
Practice Address - Country:US
Practice Address - Phone:272-212-1000
Practice Address - Fax:272-212-0201
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288670207P00000X
390200000X
PAMD463729207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program