MEDICARE: JACQUELINE SCHATZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	002596	NY
2	106H00000X	Marriage & Family Therapist	000386	NY

General Provider Information

NPI Number	:	1225286446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE SCHATZ

Provider Business Mailing Address
First Line	:	30 W 70TH ST
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10023-4636
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 W 70TH ST
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10023-4636
Country	:	US
Telephone Number	:	212-579-6531
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	08/29/2008

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Directions to “ JACQUELINE SCHATZ ” Practice Location

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