Provider Demographics
NPI:1841435013
Name:SCHWARTZ, NICOLE RAAB (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:RAAB
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:LYNETTE
Other - Last Name:RAAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:210 W 103RD ST
Mailing Address - Street 2:APT. 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8702
Mailing Address - Country:US
Mailing Address - Phone:212-349-6127
Mailing Address - Fax:
Practice Address - Street 1:210 W 103RD ST
Practice Address - Street 2:APT. 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8702
Practice Address - Country:US
Practice Address - Phone:212-349-6127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011962-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist