Provider Demographics
NPI:1497795587
Name:SCHECHTER, MENACHEM (MD)
Entity Type:Individual
Prefix:
First Name:MENACHEM
Middle Name:
Last Name:SCHECHTER
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:MOUNT KISCO MEDICAL GROUP, PC
Mailing Address - Street 2:90 SOUTH BEDFORD ROAD
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3412
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:MOUNT KISCO MEDICAL GROUP PC
Practice Address - Street 2:400 EAST MAIN STREET
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233449208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02692602Medicaid
NYI40407Medicare UPIN
NY02692602Medicaid