Healthcare Provider Details

I. General information

NPI: 1972071843
Provider Name (Legal Business Name): PATRICIA SCHUDDE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA TRETIN RN

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 BROADWAY
NEWBURGH NY
12550-5408
US

IV. Provider business mailing address

27 MATTHEWS ST
GOSHEN NY
10924-1962
US

V. Phone/Fax

Practice location:
  • Phone: 845-562-8255
  • Fax: 845-562-4140
Mailing address:
  • Phone: 845-294-5124
  • Fax: 845-294-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number542371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: