Provider Demographics
NPI:1063417491
Name:SCHWARZBERG, ISA (DPM)
Entity type:Individual
Prefix:DR
First Name:ISA
Middle Name:
Last Name:SCHWARZBERG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W PASSAIC ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1264
Mailing Address - Country:US
Mailing Address - Phone:201-880-6000
Mailing Address - Fax:201-880-5999
Practice Address - Street 1:240 W PASSAIC ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1264
Practice Address - Country:US
Practice Address - Phone:201-880-6000
Practice Address - Fax:201-880-5999
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00281000213ES0103X
MI5901002194213ES0131X
NYN005990213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPJ2531Medicare Oscar/Certification