Provider Demographics
NPI:1104822675
Name:SCHU, DEBORAH L (RNNP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:SCHU
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 ERIE BLVD EAST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224
Mailing Address - Country:US
Mailing Address - Phone:315-424-1430
Mailing Address - Fax:315-424-1779
Practice Address - Street 1:2949 ERIE BLVD E
Practice Address - Street 2:SUITE 110
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1442
Practice Address - Country:US
Practice Address - Phone:315-424-1430
Practice Address - Fax:315-424-1779
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300287363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01712803Medicaid
J400027531Medicare PIN
500021856Medicare PIN
NYBB6258Medicare ID - Type Unspecified
NYS27140Medicare UPIN