Healthcare Provider Details

I. General information

NPI: 1215274543
Provider Name (Legal Business Name): RAINA SCHUMAN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAINA VAN STRANDER

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 09/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 MT HOPE RD
MIDDLETOWN NY
10940-7135
US

IV. Provider business mailing address

23 FIRST ST
GODEFFROY NY
12729
US

V. Phone/Fax

Practice location:
  • Phone: 845-344-2292
  • Fax:
Mailing address:
  • Phone: 845-649-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number008687-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: