Provider Demographics
NPI:1023005691
Name:SCHLOSSBERG, HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:SCHLOSSBERG
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 1:896 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12148-1318
Mailing Address - Country:US
Mailing Address - Phone:518-399-4600
Mailing Address - Fax:518-399-0286
Practice Address - Street 1:3 CROSSING BLVD STE 1
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4172
Practice Address - Country:US
Practice Address - Phone:518-831-4434
Practice Address - Fax:518-831-4435
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY236530207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0202K1Medicare PIN
RA7360Medicare PIN
I34105Medicare UPIN
P00227938Medicare PIN
0202K85471Medicare PIN