Healthcare Provider Details

I. General information

NPI: 1477174688
Provider Name (Legal Business Name): RACHAEL MARIE SCHULTZ RN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 04/28/2020
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3098
US

IV. Provider business mailing address

200 BRYANT ST
BUFFALO NY
14222-2005
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-3000
  • Fax:
Mailing address:
  • Phone: 631-742-7224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number645856
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: