| Doctor Name: | MARK ALLAN SCHIMELMAN |
| NPI Number: | 1649276122 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 149089 |
| Business Practice Address: | 76 N Greenbush Rd Troy, NY - 121808369 |
| Business Phone Number: | 5182863000 |
| Business Fax Number: | 5182863008 |
| Mailing Address: | 76 N Greenbush Rd, TROY |
| State: | NY |
| Postal Code: | 121808369 |
| Phone Number: | 5182863000 |
| Fax Number: | 5182863008 |
| NPI Enumeration Date: | 06/21/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 149089 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |