Provider Demographics
NPI:1467747790
Name:SCHWARTZ, JASON TAYLOR (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:TAYLOR
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4 SPRINGVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2290
Mailing Address - Country:US
Mailing Address - Phone:631-537-3765
Mailing Address - Fax:631-537-4296
Practice Address - Street 1:386 MONTAUK HWY STE 5
Practice Address - Street 2:
Practice Address - City:WAINSCOTT
Practice Address - State:NY
Practice Address - Zip Code:11975-2000
Practice Address - Country:US
Practice Address - Phone:631-537-3765
Practice Address - Fax:631-537-4296
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2024-06-28
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Provider Licenses
StateLicense IDTaxonomies
NY267235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400122425Medicare PIN