Provider Demographics
NPI:1558401430
Name:SCHOENBAUM, ELLIE E (MD)
Entity Type:Individual
Prefix:
First Name:ELLIE
Middle Name:E
Last Name:SCHOENBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 98TH ST
Mailing Address - Street 2:APT. 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5628
Mailing Address - Country:US
Mailing Address - Phone:718-430-2518
Mailing Address - Fax:718-430-3076
Practice Address - Street 1:MMC - EPIDEMIOLOGY & POPULA.
Practice Address - Street 2:1300 MORRIS PARK AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-430-2518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144766207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism