Healthcare Provider Details

I. General information

NPI: 1851530075
Provider Name (Legal Business Name): ROBERT ERIC SCHANTZ MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 LAKE AVE
ROCHESTER NY
14608-1410
US

IV. Provider business mailing address

81 LAKE AVE
ROCHESTER NY
14608-1410
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-6901
  • Fax: 585-368-3950
Mailing address:
  • Phone: 585-368-6901
  • Fax: 585-368-3950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005168
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: