Healthcare Provider Details

I. General information

NPI: 1720162670
Provider Name (Legal Business Name): MARGARET SCHULTZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E GENESEE ST 217
SYRACUSE NY
13202-3130
US

IV. Provider business mailing address

3300 JAMES ST SUITE 100
SYRACUSE NY
13206-2387
US

V. Phone/Fax

Practice location:
  • Phone: 315-671-0717
  • Fax: 315-671-0718
Mailing address:
  • Phone: 315-422-0300
  • Fax: 315-479-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number015879-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: