Healthcare Provider Details

I. General information

NPI: 1588684112
Provider Name (Legal Business Name): AUDREY OLIVERA SCHWABE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 85TH ST
NEW YORK NY
10028-3108
US

IV. Provider business mailing address

215 E 85TH ST
NEW YORK NY
10028-3108
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-7348
  • Fax: 212-746-7311
Mailing address:
  • Phone: 646-962-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number203047
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: