Healthcare Provider Details

I. General information

NPI: 1265415962
Provider Name (Legal Business Name): CAROLYN L. SCHWARTZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 DUTCH HILL RD STE 18
ORANGEBURG NY
10962-1722
US

IV. Provider business mailing address

60 DUTCH HILL RD STE 18
ORANGEBURG NY
10962-1722
US

V. Phone/Fax

Practice location:
  • Phone: 845-359-4770
  • Fax: 458-359-0017
Mailing address:
  • Phone: 845-359-4770
  • Fax: 845-359-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA06728100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number310846
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: