Provider Demographics
NPI:1053563221
Name:SCHORR, RENEE WARD (MED)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:WARD
Last Name:SCHORR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 KENNEDY DR
Mailing Address - Street 2:APT. 713
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3325
Mailing Address - Country:US
Mailing Address - Phone:781-307-6947
Mailing Address - Fax:
Practice Address - Street 1:22 CHURCH ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-2718
Practice Address - Country:US
Practice Address - Phone:781-306-4820
Practice Address - Fax:781-393-6554
Is Sole Proprietor?:No
Enumeration Date:2008-10-19
Last Update Date:2008-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA298759174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist