Provider Demographics
NPI:1285763706
Name:SCHUMACHER, JENNIFER A (PA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:SCHUMACHER
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:725 E ADAMS ST STE 3C
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2576
Mailing Address - Country:US
Mailing Address - Phone:315-464-5533
Mailing Address - Fax:315-464-5579
Practice Address - Street 1:725 E ADAMS ST STE 3C
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2576
Practice Address - Country:US
Practice Address - Phone:315-464-5533
Practice Address - Fax:315-464-5579
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011511363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03124229Medicaid
NY03124229Medicaid