1336609825 NPI number — MRS. LAURIE FAYE SCHWARTZ M.S.

Table of content: MRS. LAURIE FAYE SCHWARTZ M.S. (NPI 1336609825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336609825 NPI number — MRS. LAURIE FAYE SCHWARTZ M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZ
Provider First Name:
LAURIE
Provider Middle Name:
FAYE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHWARTZ
Provider Other First Name:
LAURIE
Provider Other Middle Name:
FAYE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1336609825
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 W 64TH ST APT 21A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10023-7149
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-496-1727
Provider Business Mailing Address Fax Number:
212-496-1727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 W 64 ST
Provider Second Line Business Practice Location Address:
APT 21A
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-496-1727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X , with the licence number:  003884-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 003884-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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