Healthcare Provider Details

I. General information

NPI: 1063610699
Provider Name (Legal Business Name): SCHUYLER SLEEP PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 STEUBEN ST
MONTOUR FALLS NY
14865-9648
US

IV. Provider business mailing address

161 RIVERSIDE DR
BINGHAMTON NY
13905-4176
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-8639
  • Fax:
Mailing address:
  • Phone: 607-797-6363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ZIA H SHAH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 607-797-6363