Provider Demographics
NPI:1306876834
Name:SCHILLER, GERARD M (MD)
Entity type:Individual
Prefix:MR
First Name:GERARD
Middle Name:M
Last Name:SCHILLER
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 1:30 E 40TH STREET
Mailing Address - Street 2:STE 506
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-685-1232
Mailing Address - Fax:212-685-0933
Practice Address - Street 1:30 E 40TH STREET
Practice Address - Street 2:STE 506
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-685-1232
Practice Address - Fax:212-685-0933
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158690207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01079616Medicaid
NY92D421Medicare ID - Type Unspecified
NY01079616Medicaid