Provider Demographics
NPI:1699041509
Name:ELISA SCHWARTZ PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:ELISA SCHWARTZ PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-209-7219
Mailing Address - Street 1:90 BRYANT AVE APT 5EC
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1928
Mailing Address - Country:US
Mailing Address - Phone:917-209-7219
Mailing Address - Fax:914-946-6334
Practice Address - Street 1:90 BRYANT AVE APT 5EC
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1928
Practice Address - Country:US
Practice Address - Phone:917-209-7219
Practice Address - Fax:914-946-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-25
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015661-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty