Provider Demographics
NPI:1154317766
Name:SCHWARTZ, JUNE (CSW)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3343
Mailing Address - Country:US
Mailing Address - Phone:516-660-9289
Mailing Address - Fax:
Practice Address - Street 1:198 SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3343
Practice Address - Country:US
Practice Address - Phone:516-660-9289
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0436111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02148272Medicaid
NYJS0N7X7010Medicare ID - Type Unspecified
NY7481741Medicare UPIN
NY7503303Medicare UPIN
NY07246317Medicare UPIN
NY02148272Medicaid
NY5619911Medicare UPIN
NY30784Medicare UPIN
NY137332Medicare UPIN
NYN2R222Medicare UPIN