Provider Demographics
NPI:1548358161
Name:SCHILLER, KEITH EVANS (DC)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:EVANS
Last Name:SCHILLER
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 1:333 E 79TH ST
Mailing Address - Street 2:1T
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0956
Mailing Address - Country:US
Mailing Address - Phone:212-737-6258
Mailing Address - Fax:212-737-1619
Practice Address - Street 1:333 E 79TH ST
Practice Address - Street 2:1T
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0956
Practice Address - Country:US
Practice Address - Phone:212-737-6258
Practice Address - Fax:212-737-1619
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0048631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT53050Medicare UPIN
NYKSOX282010Medicare ID - Type Unspecified