1851493217 NPI number — ALAN M SCHULLER MD

Table of content: ALAN M SCHULLER MD (NPI 1851493217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851493217 NPI number — ALAN M SCHULLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULLER
Provider First Name:
ALAN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1851493217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 W CARVER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11743-3303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-421-0020
Provider Business Mailing Address Fax Number:
631-421-5991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 W CARVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-421-0020
Provider Business Practice Location Address Fax Number:
531-421-4138
Provider Enumeration Date:
09/05/2006

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: 207R00000X , with the licence number:  168753 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: 168753 , 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: AS026F8210 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 064 . This is a "NY MEDCAID SPECIALTY CODE" identifier . This identifiers is of the category "OTHER".
  • Identifier: OC8780 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110106899 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4231280 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: SA8753 . This is a "ATLANTIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1866720001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3006 . This is a "NEIC SITE ID, NSF BA0-7" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112234962 . This is a "TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1687532 . This is a "WC/NF" identifier . This identifiers is of the category "OTHER".
  • Identifier: E44640 . This is a "UNIVERSAL PERSON IDENTIFI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 003 . This is a "NY MEDCAID PROV/SRV CNTR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 168753 . This is a "MEDICAL LICENSE #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 394390 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01144274 . This is a "MEDCAID ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01144274 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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