Provider Demographics
NPI:1780682328
Name:SCHWARTZ, CHARLES A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:501 SEAVIEW AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3436
Mailing Address - Country:US
Mailing Address - Phone:718-663-7000
Mailing Address - Fax:718-663-7090
Practice Address - Street 1:1423 AMANDA DR
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28104-0059
Practice Address - Country:US
Practice Address - Phone:732-740-8510
Practice Address - Fax:732-913-5462
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY146485207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00706730Medicaid
NY00706730Medicaid
B78808Medicare UPIN