Provider Demographics
NPI:1295749984
Name:SCHIFFER, MARK BENJAMIN (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:BENJAMIN
Last Name:SCHIFFER
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 1:158 E 84TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2005
Mailing Address - Country:US
Mailing Address - Phone:212-535-6340
Mailing Address - Fax:212-535-2618
Practice Address - Street 1:158 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2005
Practice Address - Country:US
Practice Address - Phone:212-535-6340
Practice Address - Fax:212-535-2618
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13826207RC0000X
NJ70058207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
4110504-007OtherCIGNA
2C4837OtherHEALTHNET
26489POtherHIP
NP037OtherOXFORD
4464663OtherAETNA PPO
0560807OtherAETNA HMO
90A042OtherEMPIRE BLUE CROSS BLUE SH
0560807OtherAETNA HMO
4110504-007OtherCIGNA