Healthcare Provider Details

I. General information

NPI: 1306862727
Provider Name (Legal Business Name): SCHUBERT LARTIGUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 N RTE 9 W
W. HAVERSTRAW NY
10993
US

IV. Provider business mailing address

34 N ROUTE 9 W
W. HAVERSTRAW NY
10993
US

V. Phone/Fax

Practice location:
  • Phone: 845-429-7400
  • Fax: 845-429-5725
Mailing address:
  • Phone: 845-429-7400
  • Fax: 845-429-5725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number000206087
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: