Provider Demographics
NPI:1013015957
Name:SCHATTNER, GERALD E (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:E
Last Name:SCHATTNER
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 1:1300 UNION TPKE
Mailing Address - Street 2:301
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1759
Mailing Address - Country:US
Mailing Address - Phone:156-354-8686
Mailing Address - Fax:516-328-8450
Practice Address - Street 1:1300 UNION TPKE
Practice Address - Street 2:301
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:156-354-8686
Practice Address - Fax:516-328-8450
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0862862173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB11928Medicare UPIN
NY268171Medicare ID - Type Unspecified