Healthcare Provider Details

I. General information

NPI: 1114067055
Provider Name (Legal Business Name): FAITH SCHIFF OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3656 LEE RD
JEFFERSON VALLEY NY
10535-1512
US

IV. Provider business mailing address

PO BOX 68
BREWSTER NY
10509-0068
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-5151
  • Fax:
Mailing address:
  • Phone: 914-245-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5048
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: