Healthcare Provider Details

I. General information

NPI: 1861416273
Provider Name (Legal Business Name): EILEEN G. SCHEIN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EILEEN GOTTLIEB SCHEIN D.D.S.

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7303 197 STREET
FLUSHING NY
11366
US

IV. Provider business mailing address

524 CLUBHOUSE RD
WOODMERE NY
11598-1902
US

V. Phone/Fax

Practice location:
  • Phone: 516-374-7627
  • Fax:
Mailing address:
  • Phone: 516-374-7627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number043529
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: