Provider Demographics
NPI:1558446054
Name:SCHWARTZ, LAWRENCE SEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:SEAN
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 1:77 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1915
Mailing Address - Country:US
Mailing Address - Phone:914-693-3693
Mailing Address - Fax:914-693-3693
Practice Address - Street 1:240 CENTRAL PARK S
Practice Address - Street 2:SUITE 2P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1457
Practice Address - Country:US
Practice Address - Phone:212-946-1051
Practice Address - Fax:914-693-3693
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012758103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7552193OtherAETNA
NY02396454Medicaid
NYP1292190OtherOXFORD
NYP1292190OtherOXFORD
NY02396454Medicaid