Provider Demographics
NPI:1548233414
Name:IRWIN L. SCHWARTZ, MD, PC
Entity Type:Organization
Organization Name:IRWIN L. SCHWARTZ, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-751-7676
Mailing Address - Street 1:200 MAIN ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2918
Mailing Address - Country:US
Mailing Address - Phone:631-751-7676
Mailing Address - Fax:631-751-1152
Practice Address - Street 1:200 MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2918
Practice Address - Country:US
Practice Address - Phone:631-751-7676
Practice Address - Fax:631-751-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08166Medicare UPIN