Provider Demographics
NPI:1619192416
Name:SCHUMAKER, JUDITH ANN (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH ANN
Middle Name:
Last Name:SCHUMAKER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 KENDARBREN DR
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1064
Mailing Address - Country:US
Mailing Address - Phone:215-489-8760
Mailing Address - Fax:215-489-8766
Practice Address - Street 1:1780 KENDARBREN DR
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1064
Practice Address - Country:US
Practice Address - Phone:215-489-8760
Practice Address - Fax:215-489-8766
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0C002548L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015253360001OtherMA NUMBER