Healthcare Provider Details

I. General information

NPI: 1346717691
Provider Name (Legal Business Name): KAREN VERA SCHIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST RM 222
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

109 WHEDON RD APT 15
SYRACUSE NY
13219-1855
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-1800
  • Fax:
Mailing address:
  • Phone: 315-289-3740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number506881
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF341836
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: