Provider Demographics
NPI:1861453177
Name:SCHUETZ, MARY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:679 MAIN ST
Mailing Address - Street 2:REAR SUITE
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2404
Mailing Address - Country:US
Mailing Address - Phone:716-805-0755
Mailing Address - Fax:716-805-0126
Practice Address - Street 1:679 MAIN ST
Practice Address - Street 2:REAR SUITE
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2404
Practice Address - Country:US
Practice Address - Phone:716-805-0755
Practice Address - Fax:716-805-0126
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2010-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1703961208000000X, 2080P0006X, 2080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01477590Medicaid
F76669Medicare UPIN