Provider Demographics
NPI:1619122975
Name:SCHROEDER, CHARLOTTE K (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:K
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1821
Mailing Address - Country:US
Mailing Address - Phone:516-781-0797
Mailing Address - Fax:
Practice Address - Street 1:1339 TAFT AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-1821
Practice Address - Country:US
Practice Address - Phone:516-781-0797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-28
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001792-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist