Provider Demographics
NPI:1598026882
Name:SCHULTZ, SHARON (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 LAWRENCE BELL DR
Mailing Address - Street 2:SUITE115
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7074
Mailing Address - Country:US
Mailing Address - Phone:716-204-0355
Mailing Address - Fax:716-204-0354
Practice Address - Street 1:80 LAWRENCE BELL DR
Practice Address - Street 2:SUITE115
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7074
Practice Address - Country:US
Practice Address - Phone:716-204-0355
Practice Address - Fax:716-204-0354
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY424549921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY424549921OtherNY STATE TEACHING CERTIFICATE