Provider Demographics
NPI:1952481996
Name:SCHWARCZ, GLENN WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:WARREN
Last Name:SCHWARCZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SUZANNE DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:845-426-2961
Mailing Address - Fax:845-426-6514
Practice Address - Street 1:24 SUZANNE DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952
Practice Address - Country:US
Practice Address - Phone:845-426-2961
Practice Address - Fax:845-426-6514
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130433208D00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01263170Medicaid
NY01263170Medicaid
NY14G931Medicare ID - Type Unspecified