Provider Demographics
NPI:1164598108
Name:SCHLIFTMAN, ALAN BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:BRUCE
Last Name:SCHLIFTMAN
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 1:244 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604
Mailing Address - Country:US
Mailing Address - Phone:914-761-1400
Mailing Address - Fax:914-761-6905
Practice Address - Street 1:244 WESTCHESTER AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2907
Practice Address - Country:US
Practice Address - Phone:914-761-1400
Practice Address - Fax:914-761-6905
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135447207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00655192Medicaid
NYB15158Medicare UPIN
48A181ASMedicare ID - Type Unspecified