Provider Demographics
NPI:1609835487
Name:SCHWARTZ, DANIEL IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:IRA
Last Name:SCHWARTZ
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 1:336 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-1702
Mailing Address - Country:US
Mailing Address - Phone:201-664-7444
Mailing Address - Fax:201-664-8610
Practice Address - Street 1:336 CENTER AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1702
Practice Address - Country:US
Practice Address - Phone:201-664-7444
Practice Address - Fax:201-664-8610
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04123900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1253603Medicaid