Provider Demographics
NPI:1447346069
Name:SCHENENDORF, RONALD (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SCHENENDORF
Suffix:
Gender:M
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:PO BOX 1588
Mailing Address - Street 2:
Mailing Address - City:SHELTER ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11964-1588
Mailing Address - Country:US
Mailing Address - Phone:516-627-2726
Mailing Address - Fax:516-750-9085
Practice Address - Street 1:19 HILO DRIVE
Practice Address - Street 2:
Practice Address - City:SHELTER ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11964-1588
Practice Address - Country:US
Practice Address - Phone:516-627-2726
Practice Address - Fax:516-750-9085
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1316492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY43A621Medicare ID - Type Unspecified