Provider Demographics
NPI:1912210345
Name:SCHWARTZ, ILENE DAWN (RN)
Entity Type:Individual
Prefix:MRS
First Name:ILENE
Middle Name:DAWN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HAZELTON LN
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-1303
Mailing Address - Country:US
Mailing Address - Phone:845-300-1003
Mailing Address - Fax:
Practice Address - Street 1:354 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2015
Practice Address - Country:US
Practice Address - Phone:845-300-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY416311163WM0102X
NY406311163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn