Provider Demographics
NPI:1720079460
Name:SCHREIBER, LINDA (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:770 JAMES ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2117
Mailing Address - Country:US
Mailing Address - Phone:315-423-9722
Mailing Address - Fax:315-423-9687
Practice Address - Street 1:792 N MAIN ST
Practice Address - Street 2:SUITE 200A
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-1644
Practice Address - Country:US
Practice Address - Phone:315-458-8700
Practice Address - Fax:315-701-1075
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF000563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS74621Medicare UPIN
NYBB9699Medicare ID - Type Unspecified