Provider Demographics
NPI:1376587857
Name:SCHLEY, WILLIAM SHAIN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SHAIN
Last Name:SCHLEY
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 1:430 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7918
Mailing Address - Country:US
Mailing Address - Phone:212-746-2223
Mailing Address - Fax:212-746-8128
Practice Address - Street 1:449 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6310
Practice Address - Country:US
Practice Address - Phone:212-746-2223
Practice Address - Fax:212-746-8128
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106153174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD47767Medicare UPIN