Provider Demographics
NPI:1235379801
Name:SCHWAGER, CHARLES JOSEPH (LMT, AEMT-P)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOSEPH
Last Name:SCHWAGER
Suffix:
Gender:M
Credentials:LMT, AEMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 CLAFLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3433
Mailing Address - Country:US
Mailing Address - Phone:516-967-7590
Mailing Address - Fax:
Practice Address - Street 1:297 CLAFLIN BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3433
Practice Address - Country:US
Practice Address - Phone:516-967-7590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321853146L00000X
NY013920225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic