Basic Information
| Provider Information | |||||||||
| NPI: | 1689647786 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHLEIEN | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 BARNARD RD | ||||||||
| Address2: | |||||||||
| City: | LARCHMONT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105381902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148335858 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3859 BROADWAY | ||||||||
| Address2: | COLUMBIA UNIVERSITY DEPARTMT PEDIATRICS | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100321540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123047250 | ||||||||
| FaxNumber: | 2125441974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2080P0203X | 145967 | NY | X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 207LP3000X | 145967 | NY | X | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 01989160 | 05 | NY | MEDICAID |