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NPI Code Detail

MEDICARE: INTENTION INTERNAL MEDICINE, PLLC

MEDICARE: INTENTION INTERNAL MEDICINE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1134998156
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTENTION INTERNAL MEDICINE, PLLC
Provider Business Mailing Address
First Line : 609 N FRANKLIN ST
Second Line :
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 607-210-6111
Fax Number : 607-210-6110
Provider Business Practice Location Address
First Line : 609 N FRANKLIN ST
Second Line :
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 607-210-6111
Fax Number : 607-210-6110
Authorized Official
Title or Position : OWNER
Name : DR. SHANNON SCHAMEL
Credential : DO
Telephone Number : 607-227-4165
Provider Enumeration Date : 01/02/2024
Last Update Date : 01/02/2024

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