Provider Demographics
NPI:1598764375
Name:SCHWARTZREICH, EDWARD SYLVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SYLVAN
Last Name:SCHWARTZREICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 DOG RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-9693
Mailing Address - Country:US
Mailing Address - Phone:802-244-4906
Mailing Address - Fax:802-244-4906
Practice Address - Street 1:267 PEARL ST
Practice Address - Street 2:STE 10
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8564
Practice Address - Country:US
Practice Address - Phone:802-658-5300
Practice Address - Fax:802-658-2067
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT04200095762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1678Medicaid
VTOVN1678Medicaid
VTSCUN1678Medicare ID - Type Unspecified