Provider Demographics
NPI:1447251582
Name:SCHRAMKE, CAROL J (PHD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:SCHRAMKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 E NORTH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4765
Mailing Address - Country:US
Mailing Address - Phone:412-359-8860
Mailing Address - Fax:412-359-8809
Practice Address - Street 1:490 E NORTH AVE STE 500
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4765
Practice Address - Country:US
Practice Address - Phone:412-359-8860
Practice Address - Fax:412-359-8809
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006464L103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001747190Medicaid
11618664OtherCAQH
PAS70405Medicare UPIN