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NPI Code Detail

MEDICARE: JENNIFER SHULTZ

MEDICARE: JENNIFER SHULTZ
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
1174400000XSpecialist

General Provider Information

NPI Number : 1386076271
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SHULTZ
Provider Business Mailing Address
First Line : 3422 76TH ST
Second Line : APT 2
City : JACKSON HEIGHTS
State : NY
Zip : 11372-2269
Country : US
Telephone Number : 917-622-2499
Fax Number :
Provider Business Practice Location Address
First Line : 3422 76TH ST
Second Line : APT 2
City : JACKSON HEIGHTS
State : NY
Zip : 11372-2269
Country : US
Telephone Number : 917-622-2499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2013
Last Update Date : 08/02/2013

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Directions to “ JENNIFER SHULTZ ” Practice Location

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