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General NPI Number Information
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NPI Number | 1134106750
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Entity Type | Individual
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Provider Name | MARTINA MARIE SCHULZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 176 TOLLGATE RD WARWICK PSYCH CENTER
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City | WARWICK
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State | RI
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Zip | 02886
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Country | US
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Telephone | 401-621-8700
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Fax | 401-621-8705
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Provider Business Mailing Address
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Address Line | 120 CENTERVILLE RD WARWICK PSYCH CENTER
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City | WARWICK
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State | RI
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Zip | 02886-4336
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Country | US
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Telephone | 401-738-3730
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Fax | 401-738-3777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00154
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License Number State | RI
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