Provider Demographics
NPI:1225004708
Name:SCHENKER, JOSEF D (MD)
Entity Type:Individual
Prefix:
First Name:JOSEF
Middle Name:D
Last Name:SCHENKER
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 1:461 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4705
Mailing Address - Country:US
Mailing Address - Phone:201-266-0513
Mailing Address - Fax:201-266-0731
Practice Address - Street 1:6122G FRESH POND RD
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1040
Practice Address - Country:US
Practice Address - Phone:718-502-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230221-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1402Q1OtherBLUECROSS BLUESHIELD
NY02623045Medicaid
NY1402Q1OtherBLUECROSS BLUESHIELD
1012Q1Medicare ID - Type Unspecified