Provider Demographics
NPI:1124170428
Name:SCHWARZ, KATHLEEN M (PT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 KINGS CROFT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1101
Mailing Address - Country:US
Mailing Address - Phone:267-679-5985
Mailing Address - Fax:
Practice Address - Street 1:1415 ROUTE 70 E
Practice Address - Street 2:SUITE 412
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2210
Practice Address - Country:US
Practice Address - Phone:856-795-0010
Practice Address - Fax:856-354-2243
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01031200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1124170428Medicare PIN