Provider Demographics
NPI:1295736817
Name:SCHNALL, H ALAN (MD)
Entity type:Individual
Prefix:
First Name:H ALAN
Middle Name:
Last Name:SCHNALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 45 QUEENS BOULEVARD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-520-0600
Mailing Address - Fax:
Practice Address - Street 1:110 45 QUEENS BOULEVARD
Practice Address - Street 2:SUITE 103
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-520-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2008-01-30
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
NY147739207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00973620Medicaid
NYP00083223OtherMC RR
05842GMedicare ID - Type Unspecified
NYP00083223OtherMC RR