Healthcare Provider Details

I. General information

NPI: 1457919383
Provider Name (Legal Business Name): JOANNE SCHWARTZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SPRING LN
PHILADELPHIA PA
19128-3918
US

IV. Provider business mailing address

3356 COTTMAN AVE
PHILADELPHIA PA
19149-1601
US

V. Phone/Fax

Practice location:
  • Phone: 215-482-5353
  • Fax: 215-482-3233
Mailing address:
  • Phone: 215-779-9807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberSP017983
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: