Provider Demographics
NPI:1891823704
Name:FUNG-SCHWARTZ, JENNIFER N (DPM)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:N
Last Name:FUNG-SCHWARTZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W 97TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6053
Mailing Address - Country:US
Mailing Address - Phone:212-678-2333
Mailing Address - Fax:212-678-9366
Practice Address - Street 1:50 W 97TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6053
Practice Address - Country:US
Practice Address - Phone:212-678-2333
Practice Address - Fax:212-678-9366
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004889213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNS4207OtherOXFORD
NYP62991OtherEMPIRE BCBS
NY6200711OtherGHI
NYCIGNAOther3281902
NY01475007Medicaid
NY18776838252OtherUNITED HEALTHCARE
NYNS4207OtherOXFORD
NYCIGNAOther3281902