Healthcare Provider Details

I. General information

NPI: 1851339147
Provider Name (Legal Business Name): LOUIS JOHN SCHIUMO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 COMO PARK BLVD
LANCASTER NY
14086-3068
US

IV. Provider business mailing address

38 ASCOT CIR
EAST AMHERST NY
14051-1808
US

V. Phone/Fax

Practice location:
  • Phone: 716-683-7666
  • Fax: 716-685-9265
Mailing address:
  • Phone: 716-639-4942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number39284
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: