Provider Demographics
NPI:1467595884
Name:SCHWARTZ, RICHARD J (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
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 1:875 BRIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8150
Mailing Address - Country:US
Mailing Address - Phone:716-832-0296
Mailing Address - Fax:716-832-0943
Practice Address - Street 1:435 ROWLEY RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4216
Practice Address - Country:US
Practice Address - Phone:716-684-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005070-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYUO1832Medicare UPIN