Provider Demographics
NPI:1891083358
Name:SCHUSTER, EDWARD A (OT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:A
Last Name:SCHUSTER
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 FIELD DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:WI
Mailing Address - Zip Code:53119-2259
Mailing Address - Country:US
Mailing Address - Phone:262-378-9395
Mailing Address - Fax:
Practice Address - Street 1:241 N BROADWAY STE 403
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-5819
Practice Address - Country:US
Practice Address - Phone:414-446-9291
Practice Address - Fax:414-446-8618
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2587-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist