MEDICARE: MONICA BARBARA SCHADLOW M.D.

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
1	207N00000X	Dermatology Physician	218007	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3223875	OTHER		AETNA
2	P2948372	OTHER		OXFORD

General Provider Information

NPI Number	:	1447255427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA BARBARA SCHADLOW M.D.

Provider Business Mailing Address
First Line	:	820 2ND AVE
Second Line	:	SUITE 3A
City	:	NEW YORK
State	:	NY
Zip	:	10017-4502
Country	:	US
Telephone Number	:	212-661-3376
Fax Number	:	212-661-3366

Provider Business Practice Location Address
First Line	:	820 2ND AVE
Second Line	:	SUITE 3A
City	:	NEW YORK
State	:	NY
Zip	:	10017-4502
Country	:	US
Telephone Number	:	212-661-3376
Fax Number	:	212-661-3366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	03/24/2014

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