Provider Demographics
NPI:1407254360
Name:SCHWARTZ, ELIZABETH M (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:HEIBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5 BUNKERHILL DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5703
Mailing Address - Country:US
Mailing Address - Phone:631-544-4449
Mailing Address - Fax:
Practice Address - Street 1:550 MOUNT AVE
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-1727
Practice Address - Country:US
Practice Address - Phone:631-491-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY491117-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse