Healthcare Provider Details

I. General information

NPI: 1811474745
Provider Name (Legal Business Name): CHARLES B SCHAAP JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MONTESI DR
HIGHLAND MILLS NY
10930-3048
US

IV. Provider business mailing address

12 MONTESI DR
HIGHLAND MILLS NY
10930-3048
US

V. Phone/Fax

Practice location:
  • Phone: 845-537-7787
  • Fax:
Mailing address:
  • Phone: 455-377-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number294997
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number297997
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: