Provider Demographics
NPI:1558009506
Name:SCHWARTZ, PHYLLIS (TEACHER)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 COAKLEY ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3812
Mailing Address - Country:US
Mailing Address - Phone:516-489-9225
Mailing Address - Fax:516-489-9526
Practice Address - Street 1:485 COAKLEY ST
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3812
Practice Address - Country:US
Practice Address - Phone:516-489-9225
Practice Address - Fax:516-489-9526
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY667E127742255R0406X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, BlindGroup - Single Specialty