Provider Demographics
NPI:1619066685
Name:SCHIPPER, JUDITH E (MS,NP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:E
Last Name:SCHIPPER
Suffix:
Gender:F
Credentials:MS,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 MORAINE RD
Mailing Address - Street 2:
Mailing Address - City:CAZENOVIA
Mailing Address - State:NY
Mailing Address - Zip Code:13035-9554
Mailing Address - Country:US
Mailing Address - Phone:212-263-3136
Mailing Address - Fax:212-263-3988
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:NYU MEDICAL CENTER SKIRBAL 9 R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-3136
Practice Address - Fax:212-263-3988
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302926363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMS0515962OtherDEA #
NYP00765Medicare UPIN
NY94N111Medicare ID - Type Unspecified