Provider Demographics
NPI:1689714354
Name:HUBSCHMITT, JANE K (NP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:K
Last Name:HUBSCHMITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4988 STATE HIGHWAY 30
Mailing Address - Street 2:PO BOX 517
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7520
Mailing Address - Country:US
Mailing Address - Phone:518-841-3413
Mailing Address - Fax:518-841-3425
Practice Address - Street 1:4988 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7520
Practice Address - Country:US
Practice Address - Phone:518-841-3413
Practice Address - Fax:518-841-3425
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330069363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01552212Medicaid
NY01552212Medicaid
NYBB0050Medicare ID - Type Unspecified