Provider Demographics
NPI:1346222809
Name:SCHWARTZ, PHILIP J (OD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 HIGHLAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4140
Mailing Address - Country:US
Mailing Address - Phone:717-569-7107
Mailing Address - Fax:717-560-3503
Practice Address - Street 1:418 HIGHLAND VIEW DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4140
Practice Address - Country:US
Practice Address - Phone:717-569-7107
Practice Address - Fax:717-560-3503
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0442490001Medicare NSC
PASC085908Medicare ID - Type Unspecified
T28347Medicare UPIN