Individual
ALAN M SCHULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W CARVER ST, HUNTINGTON, NY 11743
(631) 421-0020
(531) 421-4138
Mailing address
200 W CARVER ST, HUNTINGTON, NY 11743-3303
(631) 421-0020
(631) 421-5991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
168753
NY
207RG0100X
Gastroenterology Physician
Primary
168753
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003
NY MEDCAID PROV/SRV CNTR
—
01
—
01144274
MEDCAID ID
—
05
—
01144274
—
NY
01
—
064
NY MEDCAID SPECIALTY CODE
—
01
—
110106899
RAILROAD MEDICARE
—
01
—
112234962
TAX ID
—
01
—
168753
MEDICAL LICENSE #
—
01
—
1687532
WC/NF
—
01
—
1866720001
CIGNA
—
01
—
3006
NEIC SITE ID, NSF BA0-7
—
01
—
394390
CONNECTICARE
—
01
—
4231280
AETNA
—
01
—
AS026F8210
BCBS
—
01
—
E44640
UNIVERSAL PERSON IDENTIFI
—
01
—
OC8780
HEALTHNET
—
01
—
SA8753
ATLANTIS
—
Enumeration date
09/05/2006
Last updated
03/20/2014
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