Healthcare Provider Details

I. General information

NPI: 1912210345
Provider Name (Legal Business Name): ILENE DAWN SCHWARTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 PHILLIPS HILL RD
NEW CITY NY
10956-2015
US

IV. Provider business mailing address

5 HAZELTON LN
WEST NYACK NY
10994-1303
US

V. Phone/Fax

Practice location:
  • Phone: 845-300-1003
  • Fax:
Mailing address:
  • Phone: 845-300-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number416311
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number406311
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: