Healthcare Provider Details
I. General information
NPI: 1285105619
Provider Name (Legal Business Name): EDWARD B SCHWARTZ PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2018
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2338 HUNTINGDON PIKE
HUNTINGDON VALLEY PA
19006-6110
US
IV. Provider business mailing address
2338 HUNTINGDON PIKE
HUNTINGDON VALLEY PA
19006-6110
US
V. Phone/Fax
- Phone: 215-947-2784
- Fax: 215-947-5310
- Phone: 215-947-2784
- Fax: 215-947-5310
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EDWARD
B.
SCHWARTZ
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 215-947-2784