Provider Demographics
NPI:1184717639
Name:SCHWARTZ, DOUGLAS ANTHONY (DO)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ANTHONY
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:DOUGLAS A SCHWARTZ D.O., P.C. EASTSIDE MEDICAL GROUP
Mailing Address - Street 2:211 EAST 43RD ST RM 2300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4717
Mailing Address - Country:US
Mailing Address - Phone:212-644-6900
Mailing Address - Fax:212-644-9600
Practice Address - Street 1:DR DOUGLAS A SCHWARTZ/ EASTSIDE MEDICAL GROUP
Practice Address - Street 2:211 EAST 43RD STREET, ROOM 2300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4717
Practice Address - Country:US
Practice Address - Phone:212-644-6900
Practice Address - Fax:212-644-9600
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2020-05-18
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Provider Licenses
StateLicense IDTaxonomies
NY184275208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01591226Medicaid
NY01591226Medicaid
NYWAW401Medicare ID - Type Unspecified
NY97K261Medicare ID - Type Unspecified