Provider Demographics
NPI:1962968685
Name:SCHUMAN, ELLEN J (MSN)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:J
Last Name:SCHUMAN
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 1ST AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2352
Mailing Address - Country:US
Mailing Address - Phone:631-644-0353
Mailing Address - Fax:
Practice Address - Street 1:275 1ST AVE APT 2B
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2352
Practice Address - Country:US
Practice Address - Phone:631-644-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381354-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics