Basic Information
| Provider Information | |||||||||
| NPI: | 1497809784 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHLUSSEL | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 247 ROUTE 100 | ||||||||
| Address2: | SUITE 1002 | ||||||||
| City: | SOMERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105893231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149628290 | ||||||||
| FaxNumber: | 9149628851 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 WHITE PLAINS RD | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | TARRYTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105915535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144938628 | ||||||||
| FaxNumber: | 9144938564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 01/29/2014 | ||||||||
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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 | 174400000X | 172315 | NY | N | Other Service Providers | Specialist | 208800000X | 172315 | NY | Y | Allopathic & Osteopathic Physicians | Urology | 2088P0231X | 172315 | NY | N | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology |
ID Information
| ID | Type | State | Issuer | Description | 1000399 | 01 | NY | GHI CBP | OTHER | 001527893 | 05 | NY | MEDICAID | 7090888 | 01 | NY | CIGNA | OTHER | 32R313 | 01 | NY | BCBS 96TH | OTHER | 32R312 | 01 | NY | BCBS HIP | OTHER | 510881 | 01 | NY | AETNA | OTHER | NS3587 | 01 | NY | OXFORD | OTHER | 1302466 | 01 | NY | UNHC | OTHER | 144319P | 01 | NY | HIP | OTHER | 3C51416 | 01 | NY | HEALTHNET | OTHER |