MEDICARE: MS. LINDA ANN BACCARI-SCHULTZ MASTERS DEGREE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1417081712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA ANN BACCARI-SCHULTZ MASTERS DEGREE

Provider Business Mailing Address
First Line	:	P.O. BOX 180
Second Line	:
City	:	SHIRLEY
State	:	NY
Zip	:	11967-4219
Country	:	US
Telephone Number	:	612-816-3487
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 SAINT GEORGE DRIVE WEST
Second Line	:
City	:	SHIRLEY
State	:	NY
Zip	:	11967-4219
Country	:	US
Telephone Number	:	631-816-3487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	10/13/2021

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