Provider Demographics
NPI:1184686628
Name:SCHWARTZBURT, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SCHWARTZBURT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT ST STE 309
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-1133
Mailing Address - Country:US
Mailing Address - Phone:718-622-1120
Mailing Address - Fax:718-622-1128
Practice Address - Street 1:26 COURT ST STE 309
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1133
Practice Address - Country:US
Practice Address - Phone:718-622-1120
Practice Address - Fax:718-622-1128
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188051207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01405036Medicaid
NY01405036Medicaid
52H621Medicare ID - Type Unspecified