Provider Demographics
NPI:1902097157
Name:SCHOR, JONATHAN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ANDREW
Last Name:SCHOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:501 SEAVIEW AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3419
Mailing Address - Country:US
Mailing Address - Phone:718-226-6800
Mailing Address - Fax:718-226-1295
Practice Address - Street 1:501 SEAVIEW AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3419
Practice Address - Country:US
Practice Address - Phone:718-226-6800
Practice Address - Fax:718-226-1295
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2013-12-02
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Provider Licenses
StateLicense IDTaxonomies
NY236577208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03236371Medicaid
NYA400030559Medicare PIN