Healthcare Provider Details

I. General information

NPI: 1508971821
Provider Name (Legal Business Name): ERIC ANDREW SCHWARTZ M.ED., ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HIGH ST
ALLENTOWN NJ
08501-1900
US

IV. Provider business mailing address

738 ESTATES BLVD APT 231
MERCERVILLE NJ
08619-2627
US

V. Phone/Fax

Practice location:
  • Phone: 609-259-3761
  • Fax:
Mailing address:
  • Phone: 609-631-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number25MT00091800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: