Provider Demographics
NPI:1477830933
Name:SCHULTZ, ANGELA ANNE (DPT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ANNE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ANNE
Other - Last Name:VARCASIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 VERNON DR
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6121
Mailing Address - Country:US
Mailing Address - Phone:914-574-5530
Mailing Address - Fax:
Practice Address - Street 1:25 VERNON DR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6121
Practice Address - Country:US
Practice Address - Phone:914-574-5530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033474225100000X
CT008986225100000X
MA16549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist