Provider Demographics
NPI:1750816690
Name:SCHWARTZ, LISA (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:475 IRVING AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1691
Mailing Address - Country:US
Mailing Address - Phone:315-671-0070
Mailing Address - Fax:315-475-0620
Practice Address - Street 1:475 IRVING AVE STE 108
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1691
Practice Address - Country:US
Practice Address - Phone:315-671-0070
Practice Address - Fax:315-475-0620
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1750816690207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology