Provider Demographics
NPI:1235212002
Name:PETER SCHWARTZ, MD, PLLC
Entity Type:Organization
Organization Name:PETER SCHWARTZ, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-266-7600
Mailing Address - Street 1:2333 NORTH TRIPHAMMER ROAD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1075
Mailing Address - Country:US
Mailing Address - Phone:607-266-7600
Mailing Address - Fax:607-266-7601
Practice Address - Street 1:2333 NORTH TRIPHAMMER ROAD
Practice Address - Street 2:SUITE 403
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1075
Practice Address - Country:US
Practice Address - Phone:607-266-7600
Practice Address - Fax:607-266-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192270207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0793Medicare UPIN