Healthcare Provider Details

I. General information

NPI: 1649291808
Provider Name (Legal Business Name): TJARK C SCHLIEP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 MALCOLM X BLVD WP 522
NEW YORK NY
10037-1802
US

IV. Provider business mailing address

506 MALCOLM X BLVD WP 522
NEW YORK NY
10037-1802
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-2740
  • Fax: 212-939-2759
Mailing address:
  • Phone: 212-939-2740
  • Fax: 212-939-2759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number000887
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: