Healthcare Provider Details

I. General information

NPI: 1609966027
Provider Name (Legal Business Name): JEFFREY ALAN SCHOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 JERICHO TPKE
SYOSSET NY
11791-4522
US

IV. Provider business mailing address

1 HOLLOW LN STE 301
NEW HYDE PARK NY
11042-1215
US

V. Phone/Fax

Practice location:
  • Phone: 516-677-5437
  • Fax: 516-282-0999
Mailing address:
  • Phone: 516-869-0650
  • Fax: 516-869-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number269741
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number203142
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: