Provider Demographics
NPI:1144409251
Name:SCHAUMBERG, ELKE (MSPT)
Entity type:Individual
Prefix:MS
First Name:ELKE
Middle Name:
Last Name:SCHAUMBERG
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 SMITHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-3500
Mailing Address - Country:US
Mailing Address - Phone:401-722-0012
Mailing Address - Fax:401-722-0056
Practice Address - Street 1:872 SMITHFIELD AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-3500
Practice Address - Country:US
Practice Address - Phone:401-722-0012
Practice Address - Fax:401-722-0056
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist