Individual provider Active NPI

Ethlynn Susan Schorr, M.D.

  • Procedural Dermatology Physician
  • Paramus, NJ
National Provider Identifier
1780664599
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
25MA08161800 Issued in NJ
Practice address
4 Forest Ave
Paramus, NJ 07652-5214
Phone
(201) 587-0500
Fax
(201) 587-0209
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 150799 NY
Procedural Dermatology Physician 207NS0135X 25MA08161800 NJ Primary

Addresses

Primary practice location

4 Forest Ave
Paramus, NJ 07652-5214

Mailing address

4 Forest Ave
Paramus, NJ 07652-5214
Phone (201) 587-0500

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08161800NJMDProcedural Dermatology Physician
150799NYMDProcedural Dermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1780664599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FOREST AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525214",
            "telephone_number": "201-587-0500",
            "fax_number": "201-587-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FOREST AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525214",
            "telephone_number": "201-587-0500",
            "fax_number": "201-587-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHORR",
        "first_name": "ETHLYNN",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "150799",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NJ",
            "license": "25MA08161800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.