MEDICARE: DR. DOUGLAS C SCHOTTENSTEIN 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	208VP0014X	Interventional Pain Medicine Physician	232232-1	NY

General Provider Information

NPI Number	:	1780617076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS C SCHOTTENSTEIN M.D.

Provider Business Mailing Address
First Line	:	18 E 48TH ST
Second Line	:	SUITE 901
City	:	NEW YORK
State	:	NY
Zip	:	10017-1014
Country	:	US
Telephone Number	:	212-750-1155
Fax Number	:	212-750-1170

Provider Business Practice Location Address
First Line	:	18 E 48TH ST
Second Line	:	SUITE 901
City	:	NEW YORK
State	:	NY
Zip	:	10017-1014
Country	:	US
Telephone Number	:	212-750-1155
Fax Number	:	212-750-1170

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	05/16/2016

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