Provider Demographics
NPI:1750454203
Name:SCHUMAN, ELLIOTT PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:PAUL
Last Name:SCHUMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PROSPECT PARK WEST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3710
Mailing Address - Country:US
Mailing Address - Phone:718-768-6664
Mailing Address - Fax:
Practice Address - Street 1:116 PROSPECT PARK WEST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3710
Practice Address - Country:US
Practice Address - Phone:718-768-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1937103T00000X
NY188103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00963786Medicaid
NYS01937OtherWORKERS COMPENSATION
V1230100Medicare ID - Type Unspecified