Healthcare Provider Details

I. General information

NPI: 1871955807
Provider Name (Legal Business Name): MEDICAL DIRECTOR SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11974 EDGEHILL TERRACE RD
PRINCESS ANNE MD
21853-2105
US

IV. Provider business mailing address

4770 WHITE PLAINS RD
BRONX NY
10470-1104
US

V. Phone/Fax

Practice location:
  • Phone: 212-734-6621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEF SCHENKER
Title or Position: BILLER
Credential:
Phone: 212-734-6621