Healthcare Provider Details

I. General information

NPI: 1023190022
Provider Name (Legal Business Name): JOHN GREGORY SCHULTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 JOHN ROEMMELT DR SUITE 301
HORSEHEADS NY
14845-8301
US

IV. Provider business mailing address

571 SAINT JOSEPHS BLVD 2ND FLOOR
ELMIRA NY
14901-3230
US

V. Phone/Fax

Practice location:
  • Phone: 607-739-0352
  • Fax: 607-739-6909
Mailing address:
  • Phone: 607-271-2050
  • Fax: 607-271-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number159706
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: