Provider Demographics
NPI:1497361349
Name:SCHWARTZ, IRA (PHD)
Entity Type:Individual
Prefix:MR
First Name:IRA
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 OCEAN AVENUE, APT. PHH
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3030
Mailing Address - Country:US
Mailing Address - Phone:718-790-8047
Mailing Address - Fax:718-627-0127
Practice Address - Street 1:2350 OCEAN AVENUE, APT. PHH
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3030
Practice Address - Country:US
Practice Address - Phone:718-790-8047
Practice Address - Fax:718-627-0127
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4103103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical