MEDICARE: DR. STIMSON PRYOR SCHANTZ 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	174400000X	Specialist	184777	NY

General Provider Information

NPI Number	:	1851350235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STIMSON PRYOR SCHANTZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2625
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10009-8925
Country	:	US
Telephone Number	:	914-222-0828
Fax Number	:	646-928-2360

Provider Business Practice Location Address
First Line	:	3916 PRINCE ST STE 152
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5367
Country	:	US
Telephone Number	:	718-353-7701
Fax Number	:

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	03/28/2018

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