Provider Demographics
NPI:1801833520
Name:SCHWARTZ, MARK PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:PHILIP
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:116 VILLAGE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5700
Mailing Address - Country:US
Mailing Address - Phone:732-600-7221
Mailing Address - Fax:609-951-2209
Practice Address - Street 1:116 VILLAGE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5700
Practice Address - Country:US
Practice Address - Phone:732-600-7221
Practice Address - Fax:609-951-2209
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA04885900207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32937Medicare UPIN