Provider Demographics
NPI:1306060322
Name:SCHUTZ, SHARON LYNN (OD OPTOMETRIST)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LYNN
Last Name:SCHUTZ
Suffix:
Gender:F
Credentials:OD OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 POPLAR COURT
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1508
Mailing Address - Country:US
Mailing Address - Phone:716-741-0220
Mailing Address - Fax:716-695-0112
Practice Address - Street 1:4244 DELAWARE AVENUE
Practice Address - Street 2:COUNCIL OPTICIANS OF TONAWANDA INC
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-6120
Practice Address - Country:US
Practice Address - Phone:716-695-3733
Practice Address - Fax:716-695-0112
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYTUV003292152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYTUV003292OtherLICENSE #
NY00634491Medicaid
NYTUV003292OtherLICENSE #
NY00634491Medicaid