Provider Demographics
NPI:1316046139
Name:SCHWARTZ, ERIC A (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:A
Last Name:SCHWARTZ
Suffix:
Gender:M
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:ONE BROOKLINE PLACE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7296
Mailing Address - Country:US
Mailing Address - Phone:617-277-8332
Mailing Address - Fax:617-277-8105
Practice Address - Street 1:ONE BROOKLINE PLACE
Practice Address - Street 2:SUITE 406
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7296
Practice Address - Country:US
Practice Address - Phone:617-277-8332
Practice Address - Fax:617-277-8105
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46642207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ0105605Medicare PIN
J0105601Medicare PIN