Provider Demographics
NPI:1326773003
Name:SCHATZLE, ERIN GRACE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:GRACE
Last Name:SCHATZLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 CARMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1301
Mailing Address - Country:US
Mailing Address - Phone:516-343-6120
Mailing Address - Fax:
Practice Address - Street 1:91 CARMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1301
Practice Address - Country:US
Practice Address - Phone:516-343-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY911653151174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist