Provider Demographics
NPI:1588125272
Name:SCHENKER, ALYSHA
Entity type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:SCHENKER
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 1:76 BUNTING BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COOKSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08511-1105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 M AND M PL
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-1336
Practice Address - Country:US
Practice Address - Phone:207-255-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5283208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation