Provider Demographics
NPI:1720656853
Name:SCHULTE, COLLEEN KELLY (APN)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:KELLY
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:KELLY
Other - Last Name:DERIGGI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:77 VERONICA AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-6804
Mailing Address - Country:US
Mailing Address - Phone:732-246-1311
Mailing Address - Fax:732-729-1927
Practice Address - Street 1:77 VERONICA AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-6804
Practice Address - Country:US
Practice Address - Phone:732-246-1311
Practice Address - Fax:732-729-1927
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ011621002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology