Healthcare Provider Details

I. General information

NPI: 1295896314
Provider Name (Legal Business Name): STEFAN SCHUMACHER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 FINNEY BLVD
MALONE NY
12953-1067
US

IV. Provider business mailing address

751 COUNTY ROUTE 27
OWLS HEAD NY
12969-1803
US

V. Phone/Fax

Practice location:
  • Phone: 518-481-8160
  • Fax: 518-481-8161
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: