=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508130402
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL CARE MEDICAL OF NY, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2012
-----------------------------------------------------
Last Update Date | 02/24/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 MARCUS AVE SUITE W95
-----------------------------------------------------
City | NEW HYDE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11042-2061
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-442-4077
-----------------------------------------------------
Fax | 516-442-2278
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 MARCUS AVE SUITE W95
-----------------------------------------------------
City | NEW HYDE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11042-2061
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-442-4077
-----------------------------------------------------
Fax | 516-442-2278
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. CHARLENE M SCHEIM
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 516-442-4077
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------