Provider Demographics
NPI:1558345520
Name:SCHWARTZ, ELISA (PT)
Entity Type:Individual
Prefix:MS
First Name:ELISA
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BRYANT AVE
Mailing Address - Street 2:APT. 5EC
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1952
Mailing Address - Country:US
Mailing Address - Phone:914-946-6334
Mailing Address - Fax:
Practice Address - Street 1:90 BRYANT AVE
Practice Address - Street 2:APT. 5EC
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1952
Practice Address - Country:US
Practice Address - Phone:914-946-6334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015661-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist