Provider Demographics
NPI:1548482730
Name:SCHWAGERL, MARYLOU
Entity type:Individual
Prefix:MRS
First Name:MARYLOU
Middle Name:
Last Name:SCHWAGERL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2106
Mailing Address - Country:US
Mailing Address - Phone:516-364-2462
Mailing Address - Fax:
Practice Address - Street 1:50 CALVIN AVE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2106
Practice Address - Country:US
Practice Address - Phone:516-364-2462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0002991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical