Provider Demographics
NPI:1902966997
Name:SCHEUBLIN, MARC JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:JOHN
Last Name:SCHEUBLIN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1000 SILVER STREET
Mailing Address - Street 2:CONNECTICUT VALLEY HOSPITAL
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3940
Mailing Address - Country:US
Mailing Address - Phone:860-262-5868
Mailing Address - Fax:
Practice Address - Street 1:1000 SILVER STREET
Practice Address - Street 2:CONNECTICUT VALLEY HOSPITAL
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3940
Practice Address - Country:US
Practice Address - Phone:860-262-5868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY231049-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY231049-1OtherMEDICAL LICENSE