Provider Demographics
NPI:1710169578
Name:MICHAEL SCHLOSS MD PC
Entity Type:Organization
Organization Name:MICHAEL SCHLOSS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-213-2900
Mailing Address - Street 1:304A E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8303
Mailing Address - Country:US
Mailing Address - Phone:212-213-2900
Mailing Address - Fax:212-696-9388
Practice Address - Street 1:304A E 30TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8303
Practice Address - Country:US
Practice Address - Phone:212-213-2900
Practice Address - Fax:212-696-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112610261QM2500X
NYF302926363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY61142100OtherMEDICARE
NY61142100OtherMEDICARE