Provider Demographics
NPI:1316112949
Name:SCHWARTZ, JOANNA ELLEN (MD)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:ELLEN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 SECOND AVENUE SUITE 2000
Mailing Address - Street 2:PRIMARY CARE ASSOCIATES
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451
Mailing Address - Country:US
Mailing Address - Phone:781-487-4040
Mailing Address - Fax:781-487-2870
Practice Address - Street 1:52 SECOND AVENUE SUITE 2000
Practice Address - Street 2:PRIMARY CARE ASSOCIATES
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451
Practice Address - Country:US
Practice Address - Phone:781-487-4040
Practice Address - Fax:781-487-2870
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA250003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program