Provider Demographics
NPI:1033400809
Name:SCHWARTZ, ANDREA (SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W 93RD ST
Mailing Address - Street 2:#8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7536
Mailing Address - Country:US
Mailing Address - Phone:212-666-6134
Mailing Address - Fax:
Practice Address - Street 1:124 W 93RD ST
Practice Address - Street 2:#8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7536
Practice Address - Country:US
Practice Address - Phone:212-666-6134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011119-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist