Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 160828 | NY |
NPI | 1114961687 |
---|---|
Provider Name | Dr. Russell J. Schiff |
First Address | Woodbury, NY 11797-2002 |
Second Address | Woodbury, NY 11797-2002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 23/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01069869 | (05) | NY |
A63831 | (02) | NY |