MEDICARE: SEEDLING DEVELOPMENTAL, INC.

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	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	170396	NY
2	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1598067597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEEDLING DEVELOPMENTAL, INC.

Provider Business Mailing Address
First Line	:	679 MAIN ST
Second Line	:	REAR SUITE
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2404
Country	:	US
Telephone Number	:	716-805-0755
Fax Number	:	716-805-0126

Provider Business Practice Location Address
First Line	:	679 MAIN ST
Second Line	:	REAR SUITE
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2404
Country	:	US
Telephone Number	:	716-805-0755
Fax Number	:	716-805-0126

Authorized Official
Title or Position	:	DEVELOPMENTAL PEDIATRICIAN
Name	:	DR. MARY E SCHUETZ
Credential	:	M.D.
Telephone Number	:	716-805-0755

Provider Enumeration Date	:	11/23/2010
Last Update Date	:	11/23/2010

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