Provider Demographics
NPI:1811151756
Name:SCHWARTZ, SHAUNA DANA (MD)
Entity type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:DANA
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 1:200 E 27TH ST
Mailing Address - Street 2:3N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9202
Mailing Address - Country:US
Mailing Address - Phone:917-613-9022
Mailing Address - Fax:
Practice Address - Street 1:200 E 27TH ST
Practice Address - Street 2:3N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9202
Practice Address - Country:US
Practice Address - Phone:917-613-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251988207R00000X
MDD87237207R00000X
VT042.0014440207R00000X
MTMED-PHYS-LIC-80094207R00000X
MI4301119419207R00000X
NJ25MA09577600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine