Provider Demographics
NPI:1497923569
Name:SCHATZ, ERIC J (CPO)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:J
Last Name:SCHATZ
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2873
Mailing Address - Country:US
Mailing Address - Phone:631-563-4550
Mailing Address - Fax:631-563-4540
Practice Address - Street 1:37 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3104
Practice Address - Country:US
Practice Address - Phone:516-279-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02056375Medicaid