Provider Demographics
NPI:1528563293
Name:SCHWERDT, MARY KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:SCHWERDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15018 61ST RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1208
Mailing Address - Country:US
Mailing Address - Phone:917-683-9872
Mailing Address - Fax:
Practice Address - Street 1:6 OHIO DR STE 202
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1129
Practice Address - Country:US
Practice Address - Phone:516-304-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program