Provider Demographics
NPI:1962543942
Name:SCHWARTZ, SAMUEL BERNARD (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:BERNARD
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:492 N RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1108
Mailing Address - Country:US
Mailing Address - Phone:914-939-0558
Mailing Address - Fax:914-509-5140
Practice Address - Street 1:492 N RIDGE ST
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-1108
Practice Address - Country:US
Practice Address - Phone:914-939-0558
Practice Address - Fax:914-509-5140
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor