Provider Demographics
NPI:1972547065
Name:SCHNELLER, STANLEY JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JAY
Last Name:SCHNELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:161 FORT WASHINGTON AVENUE
Mailing Address - Street 2:SUITE 546
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-5490
Mailing Address - Fax:212-305-8109
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE 546
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-5490
Practice Address - Fax:212-305-8109
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY137224207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY41D612Medicare ID - Type Unspecified
NYB14326Medicare UPIN