Provider Demographics
NPI:1851497150
Name:BRIAN J. SCHULTZ, D.P.M., P.C.
Entity Type:Organization
Organization Name:BRIAN J. SCHULTZ, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-725-9090
Mailing Address - Street 1:161 MADISON AVENUE
Mailing Address - Street 2:SUITE 9NE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-725-9090
Mailing Address - Fax:212-725-1040
Practice Address - Street 1:161 MADISON AVENUE
Practice Address - Street 2:SUITE 9NE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-725-9090
Practice Address - Fax:212-725-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005054332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01518643Medicaid
NYPPWX11Medicare PIN
NY01518643Medicaid
NY5822230001Medicare NSC