Healthcare Provider Details

I. General information

NPI: 1780682328
Provider Name (Legal Business Name): CHARLES A SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 AMANDA DR
WEDDINGTON NC
28104-0059
US

IV. Provider business mailing address

501 SEAVIEW AVE STE 300
STATEN ISLAND NY
10305-3436
US

V. Phone/Fax

Practice location:
  • Phone: 732-740-8510
  • Fax: 732-913-5462
Mailing address:
  • Phone: 718-663-7000
  • Fax: 718-663-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number146485
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: