Provider Demographics
NPI:1932292950
Name:SCHUSTER, JOSEPH C (OT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:C
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 1:2010 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-1508
Mailing Address - Country:US
Mailing Address - Phone:570-963-1278
Mailing Address - Fax:570-963-1292
Practice Address - Street 1:2010 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1508
Practice Address - Country:US
Practice Address - Phone:570-963-1278
Practice Address - Fax:570-963-1292
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005321L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017604400002Medicaid
PA396772Medicare ID - Type Unspecified