Provider Demographics
NPI:1003879511
Name:SCHUSS, ALLAN L (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:L
Last Name:SCHUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 STEWART AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4886
Mailing Address - Country:US
Mailing Address - Phone:516-248-3737
Mailing Address - Fax:516-248-7304
Practice Address - Street 1:1103 STEWART AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4886
Practice Address - Country:US
Practice Address - Phone:516-222-6161
Practice Address - Fax:516-248-7304
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172203207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02335739Medicaid
819291Medicare ID - Type Unspecified
G63743Medicare UPIN