Provider Demographics
NPI:1477618742
Name:SWARTZ, BRUCE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 GARLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1121 WASHINGTON ST
Practice Address - Street 2:SUITE #4
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2149
Practice Address - Country:US
Practice Address - Phone:617-971-3007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000033045OtherBMC HEALTHNET
MA0522694Medicaid
MA550010007758OtherHARVARD PILGRIM
MA000000033045OtherBMC HEALTHNET