Provider Demographics
NPI:1760769798
Name:SCHUTZ, JOSEPH (PSY D)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SCHUTZ
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1104
Mailing Address - Country:US
Mailing Address - Phone:516-629-4558
Mailing Address - Fax:516-629-4567
Practice Address - Street 1:21 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1104
Practice Address - Country:US
Practice Address - Phone:516-629-4558
Practice Address - Fax:516-629-4567
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014283103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool