Provider Demographics
NPI:1184882243
Name:SCHULTZ, BARRATT MATTHEW (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:BARRATT
Middle Name:MATTHEW
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1571 WASHINGTON ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-9304
Mailing Address - Country:US
Mailing Address - Phone:315-782-1650
Mailing Address - Fax:315-788-8547
Practice Address - Street 1:1571 WASHINGTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-9304
Practice Address - Country:US
Practice Address - Phone:315-782-1650
Practice Address - Fax:315-788-8547
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2012-01-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVAD000Medicare UPIN