MEDICARE: JONATHAN S. SCHIFFMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	25MA06830300	NJ
2	208000000X	Pediatrics Physician	219512	NY
3	2080P0203X	Pediatric Critical Care Medicine Physician	25MA06830300	NJ
4	2080P0203X	Pediatric Critical Care Medicine Physician	219512	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528068830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN S. SCHIFFMAN MD

Provider Business Mailing Address
First Line	:	192 HIGH ST
Second Line	:
City	:	PASSAIC
State	:	NJ
Zip	:	07055-4614
Country	:	US
Telephone Number	:	973-472-0365
Fax Number	:	973-472-1007

Provider Business Practice Location Address
First Line	:	192 HIGH ST
Second Line	:
City	:	PASSAIC
State	:	NJ
Zip	:	07055-4614
Country	:	US
Telephone Number	:	973-472-0365
Fax Number	:	973-472-1007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/11/2007

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