Provider Demographics
NPI:1730652405
Name:SCHWARTZ, ADAM JUSTIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JUSTIN
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 EMPIRE AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4856
Mailing Address - Country:US
Mailing Address - Phone:845-596-1719
Mailing Address - Fax:
Practice Address - Street 1:829 EMPIRE AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4856
Practice Address - Country:US
Practice Address - Phone:845-596-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-06
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019904-1224ZR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility