Healthcare Provider Details

I. General information

NPI: 1922869494
Provider Name (Legal Business Name): TOBY SCHURAYTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 EAST LN
SUFFERN NY
10901-1907
US

IV. Provider business mailing address

15201 KENTON ST
OAK PARK MI
48237-1553
US

V. Phone/Fax

Practice location:
  • Phone: 248-906-6773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15452900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704331111
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407689
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704331111
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: