Provider Demographics
NPI:1073620118
Name:SCHWAITZBERG, STEVEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:SCHWAITZBERG
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:77 GOODELL STREET
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1243
Mailing Address - Country:US
Mailing Address - Phone:716-645-9694
Mailing Address - Fax:716-845-6699
Practice Address - Street 1:100 HIGH STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-2268
Practice Address - Fax:716-859-4580
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2020-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA55759208600000X
NY278662208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04145117Medicaid
MABLUE CROSSOther1073620118