Schuber C Fan, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MA27734 Issued in NJ

Practice address

130 Maple Ave
Suite 1a
Red Bank, NJ 07701-1734

Phone

(732) 741-1378

Fax

(732) 741-1677

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: schuber.fan@greatermonmouthneurology.chartmakerdirect.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1245205376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MAPLE AVE",
            "address_2": "SUITE 1A",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011734",
            "telephone_number": "732-741-1378",
            "fax_number": "732-741-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MAPLE AVE",
            "address_2": "SUITE 1A",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011734",
            "telephone_number": "732-741-1378",
            "fax_number": "732-741-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "SCHUBER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA27734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003402",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "0619012543",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004256293",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Compass Counseling & Mediation
• Family Practice of Middletown, LLC
• Family Resource Associates, Inc
• Family Resource Associates, Inc.
• Family Resource Associates, Inc.
• Michael Thomas Farr, MD
• Lauren Fasciani, PSY.D.
• Marina Fawzy
• Anthony Fazio, DPT
• Dara Fedele, MD

• Neurology Physician in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.