Provider Demographics
NPI:1659356285
Name:SCHLECKER, JANE ILENE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ILENE
Last Name:SCHLECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:241 BEACH 136TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1323
Mailing Address - Country:US
Mailing Address - Phone:718-634-1228
Mailing Address - Fax:718-634-1644
Practice Address - Street 1:2560 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4507
Practice Address - Country:US
Practice Address - Phone:718-646-7878
Practice Address - Fax:718-646-4259
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151524207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY151524OtherNYS LICENSE NUMBER
NYB78371Medicare UPIN
NY62D731Medicare ID - Type Unspecified