Provider Demographics
NPI:1639282486
Name:SCHMALFUSS, LINDA S (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:SCHMALFUSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 ATTRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14428
Mailing Address - Country:US
Mailing Address - Phone:585-594-1020
Mailing Address - Fax:
Practice Address - Street 1:35 ATTRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:NY
Practice Address - Zip Code:14428
Practice Address - Country:US
Practice Address - Phone:585-594-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2790621163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02009736Medicaid