Provider Demographics
NPI:1891065975
Name:SCHLOSSBERG, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SCHLOSSBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2911
Mailing Address - Country:US
Mailing Address - Phone:914-961-1010
Mailing Address - Fax:914-961-1011
Practice Address - Street 1:115 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-2911
Practice Address - Country:US
Practice Address - Phone:914-961-1010
Practice Address - Fax:914-961-1011
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2351748342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer