MEDICARE: DR. GEORGE ROBERT SCHUMACHER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	009763	NY
2	103TC0700X	Clinical Psychologist	009763	NY

General Provider Information

NPI Number	:	1760551501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ROBERT SCHUMACHER PH.D.

Provider Business Mailing Address
First Line	:	123 7TH AVE
Second Line	:	PMB #258
City	:	BROOKLYN
State	:	NY
Zip	:	11215-1301
Country	:	US
Telephone Number	:	347-228-4653
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 PLAZA ST E
Second Line	:	STE 1A
City	:	BROOKLYN
State	:	NY
Zip	:	11238-5048
Country	:	US
Telephone Number	:	347-228-4653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	02/15/2016

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