Healthcare Provider Details

I. General information

NPI: 1588642243
Provider Name (Legal Business Name): LAURA GRAY SCHOENBERG M.D.D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2037 JERICHO TPKE SCHOENBERG NEUROLOGY
NEW HYDE PARK NY
11040-4720
US

IV. Provider business mailing address

2037 JERICHO TPKE SCHOENBERG NEUROLOGY
NEW HYDE PARK NY
11040-4720
US

V. Phone/Fax

Practice location:
  • Phone: 516-358-1444
  • Fax: 516-358-2390
Mailing address:
  • Phone: 516-358-1444
  • Fax: 516-358-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number206159
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number206159
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number206159
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number206159
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number206159
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number206159
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number206159
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number206159
License Number StateNY
# 9
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number206159
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number206159
License Number StateNY
# 11
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number206159
License Number StateNY
# 12
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number206159
License Number StateNY
# 13
Primary TaxonomyN
Taxonomy Code2084P0301X
TaxonomyBrain Injury Medicine (Psychiatry & Neurology) Physician
License Number206159
License Number StateNY
# 14
Primary TaxonomyN
Taxonomy Code2084S0010X
TaxonomySports Medicine (Psychiatry & Neurology) Physician
License Number206159
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: