Provider Demographics
NPI:1801233085
Name:SCHULTZ, JOSHUA J
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:J
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COURT ST
Mailing Address - Street 2:RM.13
Mailing Address - City:BELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:14813-1044
Mailing Address - Country:US
Mailing Address - Phone:585-268-9678
Mailing Address - Fax:
Practice Address - Street 1:7 COURT ST
Practice Address - Street 2:RM.13
Practice Address - City:BELMONT
Practice Address - State:NY
Practice Address - Zip Code:14813-1044
Practice Address - Country:US
Practice Address - Phone:585-268-9678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356143Medicaid