Healthcare Provider Details

I. General information

NPI: 1023005691
Provider Name (Legal Business Name): HOWARD SCHLOSSBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CROSSING BLVD STE 1
CLIFTON PARK NY
12065-4172
US

IV. Provider business mailing address

896 RIVERVIEW RD
REXFORD NY
12148-1318
US

V. Phone/Fax

Practice location:
  • Phone: 518-831-4434
  • Fax: 518-831-4435
Mailing address:
  • Phone: 518-399-4600
  • Fax: 518-399-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number236530
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: