Provider Demographics
NPI:1407455967
Name:MARIE JEAN SCHWARZ NURSE PRACTITIONER IN PSYCHIATRY PC
Entity Type:Organization
Organization Name:MARIE JEAN SCHWARZ NURSE PRACTITIONER IN PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER OF PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:631-321-1500
Mailing Address - Street 1:133 E MAIN ST STE 3H
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3517
Mailing Address - Country:US
Mailing Address - Phone:631-321-1500
Mailing Address - Fax:631-321-1501
Practice Address - Street 1:133 E MAIN ST STE 3H
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3517
Practice Address - Country:US
Practice Address - Phone:631-321-1500
Practice Address - Fax:631-321-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-25
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03982501Medicaid