Provider Demographics
NPI:1467429159
Name:SCHWARTZ, STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BREWSTER ST
Mailing Address - Street 2:MEMORIAL HOSPITAL OF RI/ PATHOLOGY DEPARTMENT
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4400
Mailing Address - Country:US
Mailing Address - Phone:401-729-2709
Mailing Address - Fax:401-729-3886
Practice Address - Street 1:111 BREWSTER ST
Practice Address - Street 2:MEMORIAL HOSPITAL OF RI/ PATHOLOGY DEPARTMENT
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4400
Practice Address - Country:US
Practice Address - Phone:401-729-2709
Practice Address - Fax:401-729-3886
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05556207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002238Medicaid
MA110087816AMedicaid
RI007060807OtherMEDICARE PTAN
RI7002238Medicaid