Provider Demographics
NPI:1710985189
Name:SCHILANSKY, MARK (DPM)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SCHILANSKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FIVE MILE WOODS RD
Mailing Address - Street 2:CATSKILL
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-5913
Mailing Address - Country:US
Mailing Address - Phone:518-943-6800
Mailing Address - Fax:518-943-6866
Practice Address - Street 1:35 FIVE MILE WOODS RD
Practice Address - Street 2:CATSKILL
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-5913
Practice Address - Country:US
Practice Address - Phone:518-943-6800
Practice Address - Fax:518-943-6866
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2014-12-04
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-22
Provider Licenses
StateLicense IDTaxonomies
NYN003122-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00531677Medicaid
NY00531677Medicaid
NYP33801Medicare ID - Type Unspecified