Provider Demographics
NPI:1962662890
Name:DR. CHARLENE M SCHEIM, DO PLLC
Entity Type:Organization
Organization Name:DR. CHARLENE M SCHEIM, DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-261-6060
Mailing Address - Street 1:7136 110TH ST
Mailing Address - Street 2:SUITE 1L
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4852
Mailing Address - Country:US
Mailing Address - Phone:718-261-6060
Mailing Address - Fax:718-544-9365
Practice Address - Street 1:7136 110TH ST
Practice Address - Street 2:SUITE 1L
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4852
Practice Address - Country:US
Practice Address - Phone:718-261-6060
Practice Address - Fax:718-544-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236378261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0179505OtherGHI