Provider Demographics
NPI:1093767675
Name:SCHWARTZ, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2906
Mailing Address - Country:US
Mailing Address - Phone:914-946-1010
Mailing Address - Fax:914-946-1025
Practice Address - Street 1:222 WESTCHESTER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2906
Practice Address - Country:US
Practice Address - Phone:914-946-1010
Practice Address - Fax:914-946-1025
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT42365174400000X
NY232106174400000X, 207X00000X, 207K00000X, 207XX0005X
CT045346207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWKC021Medicare PIN
CTI04123Medicare UPIN
CTC03131Medicare PIN
CT200001048Medicare PIN