Provider Demographics
NPI:1629199682
Name:SCHACHTER, MICHAEL BEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BEN
Last Name:SCHACHTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4164
Mailing Address - Country:US
Mailing Address - Phone:845-368-4700
Mailing Address - Fax:845-368-4727
Practice Address - Street 1:2 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4164
Practice Address - Country:US
Practice Address - Phone:845-368-4700
Practice Address - Fax:845-368-4727
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY097295-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10673Medicare UPIN