Provider Demographics
NPI:1427435478
Name:SCHACK, ELIZABETH ELLEN (NP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:SCHACK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:525 E 68TH ST
Mailing Address - Street 2:ROOM F1401G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-1729
Mailing Address - Fax:212-746-4888
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:ROOM F1401G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-1729
Practice Address - Fax:212-746-4888
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF340614-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology