Provider Demographics
NPI:1417933540
Name:SCHULTZE, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:SCHULTZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-0298
Mailing Address - Country:US
Mailing Address - Phone:518-475-1515
Mailing Address - Fax:518-475-0645
Practice Address - Street 1:1220 NEW SCOTLAND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9208
Practice Address - Country:US
Practice Address - Phone:518-475-1515
Practice Address - Fax:518-475-0645
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY203780207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0499815OtherGHI INDEMNITY
NY141811796OtherUNITED HEALTHCARE
NY000000050848OtherGHI HMO
NY10027137OtherCDPHP
NY000470858003OtherBLUE SHIELD
NY01827834Medicaid
VT1011652OtherVT MEDICAID
NYRS044Z3710OtherEMPIRE BC/BS
NY040426006137OtherFIDELIS
NY17383OtherMVP
NYRS044Z3710OtherEMPIRE BC/BS
VT1011652OtherVT MEDICAID