Provider Demographics
NPI:1922059344
Name:SCHISKIE, MELISSA (DO)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SCHISKIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1623
Mailing Address - Country:US
Mailing Address - Phone:845-255-3046
Mailing Address - Fax:845-255-0236
Practice Address - Street 1:11 CRUM ELBOW RD
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-2852
Practice Address - Country:US
Practice Address - Phone:845-229-1020
Practice Address - Fax:845-229-2005
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225295207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02360869Medicaid
NY4193P20581Medicare PIN
NYH76778Medicare UPIN
NYDD4005Medicare ID - Type Unspecified