Provider Demographics
NPI:1609886050
Name:SCHWARTZ, GILBERT
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 NESHAMINY BLVD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1041
Mailing Address - Country:US
Mailing Address - Phone:215-752-2287
Mailing Address - Fax:215-752-7094
Practice Address - Street 1:4802 NESHAMINY BLVD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1041
Practice Address - Country:US
Practice Address - Phone:215-752-2287
Practice Address - Fax:215-752-7094
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0120791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA432624OtherVALUE OPTION
PA2319293000OtherPERSONAL CHOICE
PA7879598OtherAETNA
PA634514T19Medicare ID - Type Unspecified