Healthcare Provider Details

I. General information

NPI: 1992780134
Provider Name (Legal Business Name): SAMUEL SCHWARTZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16933 137TH AVE
JAMAICA NY
11434-4517
US

IV. Provider business mailing address

21 E 22ND ST 5 C
NEW YORK NY
10010-5332
US

V. Phone/Fax

Practice location:
  • Phone: 718-723-2100
  • Fax:
Mailing address:
  • Phone: 212-477-1725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number028406
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number028406
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number028406
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number028406
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: