MEDICARE: DR. ANN WHITNEY SCHONGALLA 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	2084P0800X	Psychiatry Physician	142601	NY

General Provider Information

NPI Number	:	1982753752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN WHITNEY SCHONGALLA M.D.

Provider Business Mailing Address
First Line	:	425 E 79TH ST
Second Line	:	1J
City	:	NEW YORK
State	:	NY
Zip	:	10075-1037
Country	:	US
Telephone Number	:	212-628-1510
Fax Number	:	914-833-1040

Provider Business Practice Location Address
First Line	:	425 E 79TH ST
Second Line	:	1J
City	:	NEW YORK
State	:	NY
Zip	:	10075-1037
Country	:	US
Telephone Number	:	212-628-1510
Fax Number	:	914-833-1040

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	09/11/2007

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