Provider Demographics
NPI:1417911934
Name:SCHWARTZ, NEIL PHILIP (OD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:PHILIP
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 1:15 REESE AVE
Mailing Address - Street 2:PO BOX 293
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4011
Mailing Address - Country:US
Mailing Address - Phone:610-353-2300
Mailing Address - Fax:610-353-2795
Practice Address - Street 1:15 REESE AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4011
Practice Address - Country:US
Practice Address - Phone:610-353-2300
Practice Address - Fax:610-353-2795
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0546339Medicaid
PA000092616OtherHIGHMARK BLUE SHIELD
PA0033103000OtherKEYSTONE
PA30928OtherAETNA
PAT28451Medicare UPIN
PA0546339Medicaid