Schackow, T. Eric

Schackow, T. Eric is an individual health care provider with primary practice located at 120 Hobart St , Utica NY 13501-4308. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Schackow, T. Eric can be contacted via phone (315) 798-1149.

Contact Information

Primary practice address
120 Hobart St Utica NY 13501-4308
Phone: (315) 798-1149
Fax: (315) 801-3565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036099827 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD456820 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 209615 New York

Profile Details

NPI number 1467435115
LBN Legal business name Schackow, T. Eric
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Jan 24th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467435115 NPPES
New York MEDICAID 01805614
New York MEDICAID 036099827
New York MEDICAID 1031143200001

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