Healthcare Provider Details

I. General information

NPI: 1063281020
Provider Name (Legal Business Name): AVI-YONAH SCHWAB PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 01/01/2024
Certification Date: 12/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 FIELDSTON RD APT 2K
BRONX NY
10463-2007
US

IV. Provider business mailing address

6116 FIELDSTON RD
BRONX NY
10471-1108
US

V. Phone/Fax

Practice location:
  • Phone: 917-509-1282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number018370
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: