Provider Demographics
NPI:1831128206
Name:SCHNAKENBERG, ERIC CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CARL
Last Name:SCHNAKENBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1783 ROUTE 9
Practice Address - Street 2:SUITE 204
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-2409
Practice Address - Country:US
Practice Address - Phone:518-371-9355
Practice Address - Fax:518-373-9139
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2016-08-24
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Provider Licenses
StateLicense IDTaxonomies
NY184866207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01403823Medicaid
NYCC9408Medicare PIN
F46440Medicare UPIN