Healthcare Provider Details

I. General information

NPI: 1508317108
Provider Name (Legal Business Name): CARLIE SCHUTTINGER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 RTE 35
SPRING LAKE NJ
07762-2543
US

IV. Provider business mailing address

2006 RTE 35
SPRING LAKE NJ
07762-2543
US

V. Phone/Fax

Practice location:
  • Phone: 732-282-0719
  • Fax:
Mailing address:
  • Phone: 732-282-0719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03825300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: