MEDICARE: ELLEN R SCHWARTZ M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SL-000104-L	PA

General Provider Information

NPI Number	:	1831420405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN R SCHWARTZ M.A.

Provider Business Mailing Address
First Line	:	295 SAINT JAMES PL
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3936
Country	:	US
Telephone Number	:	215-923-3886
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 SAINT JAMES PL
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3936
Country	:	US
Telephone Number	:	215-923-3886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	01/21/2010

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