Healthcare Provider Details

I. General information

NPI: 1932698420
Provider Name (Legal Business Name): STIMSON P SCHANTZ MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 PRINCE ST STE 152
FLUSHING NY
11354
US

IV. Provider business mailing address

PO BOX 2625
NEW YORK NY
10009-8925
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-7701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: EMILY LAM
Title or Position: BILLING AND CREDENTIALING MANAGER
Credential:
Phone: 914-222-0828