Provider Demographics
NPI:1851630693
Name:SCHEUERMAN, CAITLYN (PA-C)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:SCHEUERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BLOOMINGDALE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2070
Mailing Address - Country:US
Mailing Address - Phone:718-317-0941
Mailing Address - Fax:718-317-0942
Practice Address - Street 1:401 BLOOMINGDALE RD STE W
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2010
Practice Address - Country:US
Practice Address - Phone:718-317-0941
Practice Address - Fax:718-317-0942
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00295800363AM0700X
NY017880-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical