Healthcare Provider Details

I. General information

NPI: 1609905017
Provider Name (Legal Business Name): BELYN SCHWARTZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 CLOUDSTONE DR
SANTA FE NM
87505-9003
US

IV. Provider business mailing address

128 CLOUDSTONE DR
SANTA FE NM
87505-9003
US

V. Phone/Fax

Practice location:
  • Phone: 505-577-5791
  • Fax:
Mailing address:
  • Phone: 505-577-5791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number94-387
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number94-387
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: