Provider Demographics
NPI:1982832820
Name:SCHULTZ, GENEVIEVE L (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:L
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2820
Mailing Address - Country:US
Mailing Address - Phone:917-696-6372
Mailing Address - Fax:
Practice Address - Street 1:546 N 1ST ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2820
Practice Address - Country:US
Practice Address - Phone:917-696-6372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15558-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist