Healthcare Provider Details

I. General information

NPI: 1659356285
Provider Name (Legal Business Name): JANE ILENE SCHLECKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 OCEAN AVE
BROOKLYN NY
11229-4507
US

IV. Provider business mailing address

241 BEACH 136TH ST
BELLE HARBOR NY
11694-1323
US

V. Phone/Fax

Practice location:
  • Phone: 718-646-7878
  • Fax: 718-646-4259
Mailing address:
  • Phone: 718-634-1228
  • Fax: 718-634-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number151524
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: