Healthcare Provider Details

I. General information

NPI: 1750357091
Provider Name (Legal Business Name): IRA SANFORD SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/26/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BORTHWICK AVE SUITE 205
PORTSMOUTH NH
03801-4174
US

IV. Provider business mailing address

330 BORTHWICK AVE SUITE 205
PORTSMOUTH NH
03801-4174
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-6115
  • Fax: 603-433-5567
Mailing address:
  • Phone: 603-436-6115
  • Fax: 603-433-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberNH6334
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: