Provider Demographics
NPI:1417946294
Name:SCHIRRIPA, GEORGE THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THOMAS
Last Name:SCHIRRIPA
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 1:970 N BROADWAY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1310
Mailing Address - Country:US
Mailing Address - Phone:914-969-5050
Mailing Address - Fax:914-423-5680
Practice Address - Street 1:970 N BROADWAY
Practice Address - Street 2:SUITE 109
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1310
Practice Address - Country:US
Practice Address - Phone:914-969-5050
Practice Address - Fax:914-423-5680
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172145207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01229405Medicaid
NYE65852Medicare UPIN
50F331Medicare ID - Type Unspecified
NY01229405Medicaid