Provider Demographics
NPI:1487774956
Name:SCHMIDT, GREGORY (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OLD POST RD S
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2350
Mailing Address - Country:US
Mailing Address - Phone:914-271-2196
Mailing Address - Fax:
Practice Address - Street 1:10 OLD POST RD S
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2350
Practice Address - Country:US
Practice Address - Phone:914-271-2196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003008-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYGS0X17451Medicare ID - Type UnspecifiedMEDICARE #