Basic Information
| Provider Information | |||||||||
| NPI: | 1306963863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHREINER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S.W., L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 725 | ||||||||
| Address2: | BASSETT MEDICAL CENTER | ||||||||
| City: | COOPERSTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 133260725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075473909 | ||||||||
| FaxNumber: | 6075474986 | ||||||||
| Practice Location | |||||||||
| Address1: | 195 MAIN STREET | ||||||||
| Address2: | WORCESTER SCHOOL | ||||||||
| City: | WORCESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6073971013 | ||||||||
| FaxNumber: | 6073971014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 08/16/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 046237-R | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 22427 | 01 | WY | MEDICARE PTAN | OTHER | 01420800 | 05 | NY | MEDICAID |