Healthcare Provider Details

I. General information

NPI: 1760706436
Provider Name (Legal Business Name): JOHN DAVID SCHWERDT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 BLOOMING GROVE TPKE
NEW WINDSOR NY
12553-7846
US

IV. Provider business mailing address

161 RIVERSIDE DR SUITE M08
BINGHAMTON NY
13905-4176
US

V. Phone/Fax

Practice location:
  • Phone: 845-562-7285
  • Fax: 845-562-5779
Mailing address:
  • Phone: 607-723-7454
  • Fax: 607-723-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN006632
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0066321
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: