Provider Demographics
NPI:1023263373
Name:SCHWINDER, AVROHOM P (CRNA, MS-SLP)
Entity type:Individual
Prefix:
First Name:AVROHOM
Middle Name:P
Last Name:SCHWINDER
Suffix:
Gender:M
Credentials:CRNA, MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 AUGUST DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3801
Mailing Address - Country:US
Mailing Address - Phone:248-318-1275
Mailing Address - Fax:
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1664
Practice Address - Country:US
Practice Address - Phone:718-818-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-27
Last Update Date:2024-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17625800163WC0200X
NY58017722235Z00000X
NJ41YS00574800235Z00000X
NJ26NJ01180100367500000X
NY686536367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist