Healthcare Provider Details

I. General information

NPI: 1124005046
Provider Name (Legal Business Name): MELISSA N SCHWARTZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 TOWNSHIP LINE RD
ELKINS PARK PA
19027-2239
US

IV. Provider business mailing address

375 TOWNSHIP LINE RD
ELKINS PARK PA
19027-2239
US

V. Phone/Fax

Practice location:
  • Phone: 215-887-7380
  • Fax: 215-887-7373
Mailing address:
  • Phone: 215-887-7380
  • Fax: 215-887-7373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number0S007744L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberOS007744L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: