Healthcare Provider Details

I. General information

NPI: 1699351486
Provider Name (Legal Business Name): SPENCER M SCHELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 ROUTE 6
MAHOPAC NY
10541-1716
US

IV. Provider business mailing address

979 ROUTE 6
MAHOPAC NY
10541-1716
US

V. Phone/Fax

Practice location:
  • Phone: 845-230-2382
  • Fax: 845-347-6129
Mailing address:
  • Phone: 845-230-2382
  • Fax: 845-347-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number337237
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number337237
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number82329
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number82329
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: