Provider Demographics
NPI:1700843810
Name:SCHULZE, GERALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:J
Last Name:SCHULZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:369 EAST MAIN STREET
Mailing Address - Street 2:SUITE 18
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2800
Mailing Address - Country:US
Mailing Address - Phone:631-277-1600
Mailing Address - Fax:631-277-1638
Practice Address - Street 1:227 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1902
Practice Address - Country:US
Practice Address - Phone:516-295-5500
Practice Address - Fax:516-569-8225
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1457872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00847856Medicaid
NY00847856Medicaid
NYA400043426Medicare PIN
NYG400040625Medicare PIN
NY28D043Medicare PIN
CO7725Medicare UPIN
NYG400040645Medicare PIN
NYA400043237Medicare PIN
NYA400043239Medicare PIN