Healthcare Provider Details

I. General information

NPI: 1265427132
Provider Name (Legal Business Name): SCOTT R. SCHULTZ O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DR. SCOTT SCHULTZ 521 FRANKLIN AVENUE
NUTLEY NJ
07110
US

IV. Provider business mailing address

PO BOX 111
SUCCASUNNA NJ
07876-0111
US

V. Phone/Fax

Practice location:
  • Phone: 973-667-0600
  • Fax: 973-667-5509
Mailing address:
  • Phone: 201-869-2020
  • Fax: 973-736-8580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5451
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number5451
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number5451
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number5451
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number5451
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number5451
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number5451
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: