Provider Demographics
NPI:1942677224
Name:SCHWARTZ, SANDRA (PT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SLOCUM RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5638
Mailing Address - Country:US
Mailing Address - Phone:617-974-3347
Mailing Address - Fax:
Practice Address - Street 1:SUMMIT ORTHOPEDIC THERAPY
Practice Address - Street 2:40 WASHINGTON STREET
Practice Address - City:WELLESLY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:UM
Practice Address - Phone:781-591-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist