Individual
JACQUELINE SCHULZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6269 65TH ST, MIDDLE VILLAGE, NY 11379-1028
(917) 873-8340
Mailing address
8 BEVERLY CT, FORT SALONGA, NY 11768-1427
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1774674
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
931696447
GHI
NY
Enumeration date
03/03/2015
Last updated
03/03/2015
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