Provider Demographics
NPI:1013161355
Name:SCHEIBNER, JANE LOGSDON
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:LOGSDON
Last Name:SCHEIBNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 KING ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3334
Mailing Address - Country:US
Mailing Address - Phone:607-754-6471
Mailing Address - Fax:
Practice Address - Street 1:1977 MARSHLAND RD
Practice Address - Street 2:
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732-1440
Practice Address - Country:US
Practice Address - Phone:607-689-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005407-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005407-1OtherEDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS REGISTRATION CERTIFICATE