Healthcare Provider Details

I. General information

NPI: 1992967095
Provider Name (Legal Business Name): NEIL P. SCHWARTZ, O. D. P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 REESE AVE
NEWTOWN SQUARE PA
19073-4046
US

IV. Provider business mailing address

15 REESE AVE
NEWTOWN SQUARE PA
19073-4046
US

V. Phone/Fax

Practice location:
  • Phone: 610-353-2300
  • Fax: 610-353-2795
Mailing address:
  • Phone: 610-353-2300
  • Fax: 610-353-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOEG000575
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberOEG000575
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberOEG000575
License Number StatePA

VIII. Authorized Official

Name: DR. NEIL P SCHWARTZ
Title or Position: PRESIDENT
Credential: O. D.
Phone: 610-353-2300