Individual provider Active NPI

Elliott Harold Schreiber, EDD

  • Clinical Psychologist
  • Moorestown, NJ
National Provider Identifier
1245433101
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35S100042500 Issued in NJ
Practice address
708 Camden Ave
Moorestown, NJ 08057
Phone
(856) 235-7142
Fax
(856) 235-7142
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P5001589 PA
Clinical Psychologist 103TC0700X 35S100042500 NJ Primary

Addresses

Primary practice location

708 Camden Ave
Moorestown, NJ 08057

Mailing address

708 Camden Ave
Moorestown, NJ 08057
Phone (856) 235-7142

Other identifiers 1

IdentifierTypeStateIssuer
1451804MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35S100042500NJMDClinical Psychologist
P5001589PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245433101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CAMDEN AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "856-235-7142",
            "fax_number": "856-235-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CAMDEN AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "856-235-7142",
            "fax_number": "856-235-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHREIBER",
        "first_name": "ELLIOTT",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "P5001589",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100042500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1451804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.