Provider Demographics
NPI:1477010221
Name:SCHWARTZ, PATRICK THOMAS (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:THOMAS
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-2207
Mailing Address - Country:US
Mailing Address - Phone:570-540-9187
Mailing Address - Fax:
Practice Address - Street 1:194 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-2207
Practice Address - Country:US
Practice Address - Phone:570-540-9187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0C009334225X00000X
0C009334225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist