Healthcare Provider Details

I. General information

NPI: 1275936932
Provider Name (Legal Business Name): JOSEF SCHENKER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6122G FRESH POND RD
MIDDLE VILLAGE NY
11379-1040
US

IV. Provider business mailing address

6122 FRESH POND RD
MIDDLE VILLAGE NY
11379-1040
US

V. Phone/Fax

Practice location:
  • Phone: 718-502-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEF SHENKER
Title or Position: TREASURER
Credential:
Phone: 212-734-6621