Healthcare Provider Details

I. General information

NPI: 1437337953
Provider Name (Legal Business Name): MARK SCHILANSKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 FIVE MILE WOODS RD
CATSKILL NY
12414-5913
US

IV. Provider business mailing address

67 PROSPECT AVE SUITE 140
HUDSON NY
12534-2917
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-6800
  • Fax:
Mailing address:
  • Phone: 518-822-1124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberN003122-1
License Number StateNY

VIII. Authorized Official

Name: MARK SCHILANSKY
Title or Position: OWNER
Credential: DPM
Phone: 518-822-1124