Provider Demographics
NPI:1912158916
Name:GEORGE J SCHILLING, MD, PC
Entity type:Organization
Organization Name:GEORGE J SCHILLING, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-895-3966
Mailing Address - Street 1:45 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ILION
Mailing Address - State:NY
Mailing Address - Zip Code:13357-1710
Mailing Address - Country:US
Mailing Address - Phone:315-895-3966
Mailing Address - Fax:315-895-3967
Practice Address - Street 1:45 1ST ST
Practice Address - Street 2:
Practice Address - City:ILION
Practice Address - State:NY
Practice Address - Zip Code:13357-1710
Practice Address - Country:US
Practice Address - Phone:315-895-3966
Practice Address - Fax:315-895-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148456174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100000066Medicare PIN