Healthcare Provider Details

I. General information

NPI: 1124014824
Provider Name (Legal Business Name): RAYMOND OCONNELL SCHULTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6044 MAIN ST SUITE 106
WILLIAMSVILLE NY
14221-5411
US

IV. Provider business mailing address

6044 MAIN ST SUITE 106
WILLIAMSVILLE NY
14221-5411
US

V. Phone/Fax

Practice location:
  • Phone: 716-650-4622
  • Fax: 716-276-3400
Mailing address:
  • Phone: 716-631-8500
  • Fax: 716-631-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number1834301
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number1834301
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: