MEDICARE: MR. SAMUEL SCHWARTZ RPH

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	183500000X	Pharmacist	028406	NY
2	1835N1003X	Nutrition Support Pharmacist	028406	NY
3	1835P1200X	Pharmacotherapy Pharmacist	028406	NY
4	1835P1300X	Psychiatric Pharmacist	028406	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	028406	OTHER	NY	LICENSE PHARMACY

General Provider Information

NPI Number	:	1992780134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAMUEL SCHWARTZ RPH

Provider Business Mailing Address
First Line	:	21 E 22ND ST
Second Line	:	5 C
City	:	NEW YORK
State	:	NY
Zip	:	10010-5332
Country	:	US
Telephone Number	:	212-477-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	16933 137TH AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-4517
Country	:	US
Telephone Number	:	718-723-2100
Fax Number	:

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	09/11/2025

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