Healthcare Provider Details

I. General information

NPI: 1225940653
Provider Name (Legal Business Name): SUEANNE SCHWARTZ LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 106
LEEDS NY
12451-0106
US

IV. Provider business mailing address

PO BOX 106
LEEDS NY
12451-0106
US

V. Phone/Fax

Practice location:
  • Phone: 518-965-3177
  • Fax: 518-617-1955
Mailing address:
  • Phone: 518-965-3177
  • Fax: 518-617-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number1415931
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: