Provider Demographics
NPI:1104897131
Name:SCHREINER, EUGENE IRVING (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:IRVING
Last Name:SCHREINER
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 1:10 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1410
Mailing Address - Country:US
Mailing Address - Phone:845-534-7818
Mailing Address - Fax:845-534-4171
Practice Address - Street 1:10 ELM ST
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1410
Practice Address - Country:US
Practice Address - Phone:845-534-7818
Practice Address - Fax:845-534-4171
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110460207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00505757Medicaid
NY322712Medicare ID - Type Unspecified
NY00505757Medicaid