Healthcare Provider Details

I. General information

NPI: 1952695041
Provider Name (Legal Business Name): MEGHAN MARIE SCHOTT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 HARRISON ST
SYRACUSE NY
13210-2695
US

IV. Provider business mailing address

719 HARRISON ST
SYRACUSE NY
13210-2695
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-3265
  • Fax: 315-464-3282
Mailing address:
  • Phone: 315-464-3265
  • Fax: 315-464-3282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number345304
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number345304
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14202536-1204
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number14202536-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: