1447255427 NPI number — MONICA BARBARA SCHADLOW M.D.

Table of content: MONICA BARBARA SCHADLOW M.D. (NPI 1447255427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447255427 NPI number — MONICA BARBARA SCHADLOW M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHADLOW
Provider First Name:
MONICA
Provider Middle Name:
BARBARA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447255427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
820 2ND AVE
Provider Second Line Business Mailing Address:
SUITE 3A
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10017-4502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-661-3376
Provider Business Mailing Address Fax Number:
212-661-3366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 2ND AVE
Provider Second Line Business Practice Location Address:
SUITE 3A
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10017-4502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-661-3376
Provider Business Practice Location Address Fax Number:
212-661-3366
Provider Enumeration Date:
06/16/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  218007 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3223875 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2948372 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".