Provider Demographics
NPI:1770851685
Name:SCHWARTZ, RAYMOND C (R PH)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:C
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4213
Mailing Address - Country:US
Mailing Address - Phone:718-337-8030
Mailing Address - Fax:917-634-3412
Practice Address - Street 1:4215 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4213
Practice Address - Country:US
Practice Address - Phone:718-337-8030
Practice Address - Fax:917-634-3412
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist