Provider Demographics
NPI:1639561228
Name:SCHWARTZ, SUSAN (RN, CRNA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CRNA
Mailing Address - Street 1:1775 YORK AVE APT 34D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6922
Mailing Address - Country:US
Mailing Address - Phone:212-860-2155
Mailing Address - Fax:
Practice Address - Street 1:350 EAST 17 STREET 3RD FLOOR
Practice Address - Street 2:MOUNT SINAI BETH ISRAEL MEDICAL CENTER-DEPT OF ANESTHE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3721841367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered