Provider Demographics
NPI:1093779480
Name:SCHWARTZ, DAVID M (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 MILL POND PL
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2337
Mailing Address - Country:US
Mailing Address - Phone:215-968-1955
Mailing Address - Fax:
Practice Address - Street 1:104 PHEASANT RUN
Practice Address - Street 2:ST.114
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1821
Practice Address - Country:US
Practice Address - Phone:267-346-5337
Practice Address - Fax:267-537-5343
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG0906152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000165508OtherHIGHMARK
PA0023493000OtherPERSONAL CHOICE
PA32438OtherAETNA
PA165508Medicare ID - Type Unspecified
PA32438OtherAETNA