Healthcare Provider Details

I. General information

NPI: 1821070541
Provider Name (Legal Business Name): JEFFREY J SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK STREET YNHH, TOMPKINS BUILDING, 3RD FLOOR
NEW HAVEN CT
06510
US

IV. Provider business mailing address

20 YORK STREET YNHH, TOMPKINS BUILDING, 3RD FLOOR
NEW HAVEN CT
06510
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2802
  • Fax: 203-785-6664
Mailing address:
  • Phone: 203-785-2802
  • Fax: 203-785-6664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number029855
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: