Provider Demographics
NPI:1972860435
Name:CORTLANDT MEDICAL PROVIDERS PLLC
Entity type:Organization
Organization Name:CORTLANDT MEDICAL PROVIDERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-739-2400
Mailing Address - Street 1:1985 CROMPOND RD
Mailing Address - Street 2:BLDG D
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4146
Mailing Address - Country:US
Mailing Address - Phone:914-739-2400
Mailing Address - Fax:914-739-2691
Practice Address - Street 1:1978 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4111
Practice Address - Country:US
Practice Address - Phone:914-739-2400
Practice Address - Fax:914-739-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty