Provider Demographics
NPI:1619968260
Name:SCHWAMM, LEE H (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:H
Last Name:SCHWAMM
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 1:800 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-785-2565
Mailing Address - Fax:203-785-2317
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-2565
Practice Address - Fax:203-785-2317
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA811022084N0400X
CT739192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3137767Medicaid
MA726476OtherTUFTS HEALTH PLAN
MAJ31170OtherBCBS MA
MAJ31170Medicare ID - Type Unspecified
MA3137767Medicaid