Provider Demographics
NPI:1962580910
Name:SCHULTZ, CHARLES MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MARTIN
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:560 WHITE PLAINS ROAD
Mailing Address - Street 2:SUITE 500 - ENTA
Mailing Address - City:TARRTYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5112
Mailing Address - Country:US
Mailing Address - Phone:914-333-5800
Mailing Address - Fax:914-333-2544
Practice Address - Street 1:3219 ROUTE 46
Practice Address - Street 2:SUITE 203
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1278
Practice Address - Country:US
Practice Address - Phone:973-394-1818
Practice Address - Fax:973-394-1810
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02687600207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA02687600OtherLICENSE
NJ005674NEWMedicare PIN
D98922Medicare UPIN