Provider Demographics
NPI:1194838243
Name:SCHUMSKY, CAROLINE
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:SCHUMSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14723 69TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1731
Mailing Address - Country:US
Mailing Address - Phone:917-439-4397
Mailing Address - Fax:917-439-4397
Practice Address - Street 1:14723 69TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1731
Practice Address - Country:US
Practice Address - Phone:917-439-4397
Practice Address - Fax:917-439-4397
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00044434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00044434Medicaid
NY6013DIMedicare PIN