Provider Demographics
NPI:1043367691
Name:SCHUSTER, CARL JOHN III (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JOHN
Last Name:SCHUSTER
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 WOODMERE AVE
Mailing Address - Street 2:
Mailing Address - City:OLYPHANT
Mailing Address - State:PA
Mailing Address - Zip Code:18447-1141
Mailing Address - Country:US
Mailing Address - Phone:570-383-5040
Mailing Address - Fax:
Practice Address - Street 1:1339 MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2095
Practice Address - Country:US
Practice Address - Phone:570-383-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008677L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical