Provider Demographics
NPI:1588967384
Name:SCHRAM, JENNEAN (MS RD CDE)
Entity type:Individual
Prefix:MRS
First Name:JENNEAN
Middle Name:
Last Name:SCHRAM
Suffix:
Gender:F
Credentials:MS RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W. MAIN STREET
Mailing Address - Street 2:NOVO NORDISK DIABETES CENTER
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-294-2574
Mailing Address - Fax:732-294-2575
Practice Address - Street 1:901 W. MAIN STREET
Practice Address - Street 2:CENTRA STATE MEDICAL CENTER
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-294-2574
Practice Address - Fax:732-294-2575
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R-627780133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered