Provider Demographics
NPI:1013005123
Name:JUDITH B SCHWARTZMAN PSY D LLC
Entity Type:Organization
Organization Name:JUDITH B SCHWARTZMAN PSY D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:937-667-2121
Mailing Address - Street 1:3709 STRATHMOOR DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-1523
Mailing Address - Country:US
Mailing Address - Phone:937-667-2121
Mailing Address - Fax:937-667-9099
Practice Address - Street 1:15 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-1808
Practice Address - Country:US
Practice Address - Phone:937-667-2121
Practice Address - Fax:937-667-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9349881Medicare PIN