MEDICARE: MR. ALAN SCHULTZ M.S.N. C.P.N.P.

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	163W00000X	Registered Nurse	RN2313147	MA
2	163W00000X	Registered Nurse	702005	NY
3	363LP0200X	Pediatric Nurse Practitioner	RN2313147	MA
4	363LP0200X	Pediatric Nurse Practitioner	F382918	NY

General Provider Information

NPI Number	:	1356794127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALAN SCHULTZ M.S.N. C.P.N.P.

Provider Business Mailing Address
First Line	:	3415 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3415 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2403
Country	:	US
Telephone Number	:	718-741-2150
Fax Number	:

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

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	03/04/2026

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