Provider Demographics
NPI:1932149929
Name:SCHWARTZ, LINDEN MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:LINDEN
Middle Name:MATTHEW
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 1:1108 E WILLOW GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7663
Mailing Address - Country:US
Mailing Address - Phone:215-280-3475
Mailing Address - Fax:215-836-0300
Practice Address - Street 1:1108 E WILLOW GROVE AVE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7663
Practice Address - Country:US
Practice Address - Phone:215-233-6226
Practice Address - Fax:215-836-0300
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042758E208100000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012455270005Medicaid
PA0012455270005Medicaid
E81776Medicare UPIN