Provider Demographics
NPI:1366038564
Name:SCHWARTZ, ELAINE DOROTHY (FNP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:DOROTHY
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 94TH ST APT 25F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5697
Mailing Address - Country:US
Mailing Address - Phone:702-408-5691
Mailing Address - Fax:
Practice Address - Street 1:345 E 94TH ST APT 25F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5697
Practice Address - Country:US
Practice Address - Phone:702-408-5691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347030363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner