MEDICARE: MENUCHA SCHELLEMBERG

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	363A00000X	Physician Assistant	032290	NY

General Provider Information

NPI Number	:	1548971336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MENUCHA SCHELLEMBERG

Provider Business Mailing Address
First Line	:	524 N LA BREA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2016
Country	:	US
Telephone Number	:	323-448-9461
Fax Number	:

Provider Business Practice Location Address
First Line	:	524 N LA BREA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2016
Country	:	US
Telephone Number	:	323-448-9461
Fax Number	:

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

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	11/04/2024

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Directions to “ MENUCHA SCHELLEMBERG ” Practice Location

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