Provider Demographics
NPI:1174553937
Name:SCHIFTER, DAVID ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROSS
Last Name:SCHIFTER
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 1:40 POND RD
Mailing Address - Street 2:
Mailing Address - City:KINGS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1019
Mailing Address - Country:US
Mailing Address - Phone:516-482-0247
Mailing Address - Fax:
Practice Address - Street 1:108 PROSPECT PARK W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3782
Practice Address - Country:US
Practice Address - Phone:718-499-5300
Practice Address - Fax:718-499-6161
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177026207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01394527Medicaid
NY01394527Medicaid
NY69K911Medicare ID - Type Unspecified