Provider Demographics
NPI:1003559956
Name:SCHULTHEIS, STEVEN ZACHARY
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ZACHARY
Last Name:SCHULTHEIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8C LACOSTA DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1255
Mailing Address - Country:US
Mailing Address - Phone:518-429-0254
Mailing Address - Fax:
Practice Address - Street 1:39 THIMBLEBERRY RD
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-4304
Practice Address - Country:US
Practice Address - Phone:518-429-0254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)