Provider Demographics
NPI:1447255427
Name:SCHADLOW, MONICA BARBARA (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:BARBARA
Last Name:SCHADLOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 2ND AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4502
Mailing Address - Country:US
Mailing Address - Phone:212-661-3376
Mailing Address - Fax:212-661-3366
Practice Address - Street 1:820 2ND AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4502
Practice Address - Country:US
Practice Address - Phone:212-661-3376
Practice Address - Fax:212-661-3366
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218007207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3223875OtherAETNA
P2948372OtherOXFORD
NY3K1451Medicare ID - Type Unspecified
P2948372OtherOXFORD
H99889Medicare UPIN