Provider Demographics
NPI:1770580524
Name:SCHWARTZ, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SCHWARTZ
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:PO BOX 95000-5585
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-5585
Mailing Address - Country:US
Mailing Address - Phone:856-667-1575
Mailing Address - Fax:856-210-2849
Practice Address - Street 1:620 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1795
Practice Address - Country:US
Practice Address - Phone:856-602-4000
Practice Address - Fax:856-946-1747
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 29855174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD96544Medicare UPIN
NJ542192Medicare ID - Type Unspecified