Provider Demographics
NPI:1700896248
Name:SCHMITZ, GEORGE M (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:SCHMITZ
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 1:5 CUBA HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1624
Mailing Address - Country:US
Mailing Address - Phone:631-628-5200
Mailing Address - Fax:631-628-5719
Practice Address - Street 1:5 CUBA HILL RD
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740
Practice Address - Country:US
Practice Address - Phone:631-628-5200
Practice Address - Fax:631-628-5719
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190970-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2C4953OtherHEALTHNET
NY48I751OtherBLUE CROSS/ BLUE SHIELD
NY2512044OtherGHI
NY01482131Medicaid
NYCP437OtherOXFORD
NY48I751Medicare ID - Type Unspecified
NYF760898Medicare UPIN