MEDICARE: DR. JEFFREY DAVID SCHILLER 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	207W00000X	Ophthalmology Physician	145786	NY
2	207W00000X	Ophthalmology Physician	AS9339587	NJ
3	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	AS9339587	NJ
4	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	145786	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710989470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY DAVID SCHILLER M.D.

Provider Business Mailing Address
First Line	:	1550 RICHMOND AVE
Second Line	:	SUITE 208
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1578
Country	:	US
Telephone Number	:	718-370-1001
Fax Number	:	718-370-0945

Provider Business Practice Location Address
First Line	:	1550 RICHMOND AVE
Second Line	:	SUITE 208
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1578
Country	:	US
Telephone Number	:	718-370-1001
Fax Number	:	718-370-0945

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	04/09/2024

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Directions to “ DR. JEFFREY DAVID SCHILLER M.D.” Practice Location

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