Provider Demographics
NPI:1891898987
Name:SCHONGAR, MARIE A (RN,MS,FNP-C, CDE)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:A
Last Name:SCHONGAR
Suffix:
Gender:F
Credentials:RN,MS,FNP-C, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HACKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3462
Mailing Address - Country:US
Mailing Address - Phone:518-262-5185
Mailing Address - Fax:518-262-6303
Practice Address - Street 1:25 HACKETT BOULEVARD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-262-5185
Practice Address - Fax:518-262-6303
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333936363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY361676OtherMVP HEALTHCARE
NY000499591002OtherBSNENY
NY73224OtherGHI/HMO
NY02359671Medicaid
NY10060790OtherCDPHP
NY070521000003OtherFIDELIS
NYP86517Medicare UPIN
NY02359671Medicaid