Provider Demographics
NPI:1730468158
Name:SANFORD A. SCHWARTZ, PH.D., PSYCHOLOGIST LLC
Entity Type:Organization
Organization Name:SANFORD A. SCHWARTZ, PH.D., PSYCHOLOGIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-969-7771
Mailing Address - Street 1:17502 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1502
Mailing Address - Country:US
Mailing Address - Phone:718-969-7771
Mailing Address - Fax:718-969-4647
Practice Address - Street 1:17502 73RD AVE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1502
Practice Address - Country:US
Practice Address - Phone:718-969-7771
Practice Address - Fax:718-969-4647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006763103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty