Provider Demographics
NPI:1104807247
Name:SCHLAEN, BRENDA R (MD)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:R
Last Name:SCHLAEN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:346 GRAND AVENUE
Mailing Address - Street 2:UNITED MEDICAL ASSOCIATES PC
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790
Mailing Address - Country:US
Mailing Address - Phone:607-729-8156
Mailing Address - Fax:607-729-3982
Practice Address - Street 1:1290 UPPER FRONT ST
Practice Address - Street 2:UNITED MEDICAL ASSOCIATES PC
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901
Practice Address - Country:US
Practice Address - Phone:607-722-3417
Practice Address - Fax:607-722-7610
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2011-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY237212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02727640Medicaid
NYRA8073Medicare PIN
NY02727640Medicaid