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General NPI Number Information
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NPI Number | 1316021090
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Entity Type | Organization
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Legal Business Name | DOUGLAS A SCHWARTZ, D.O., P.C. EASTSIDE MEDICAL GROUP
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 211 E 43RD ST RM 2300
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City | NEW YORK
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State | NY
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Zip | 10017-4707
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Country | US
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Telephone | 212-644-6900
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Fax | 212-644-9600
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Provider Business Mailing Address
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Address Line | 211 E 43RD ST RM 2300
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City | NEW YORK
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State | NY
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Zip | 10017-4707
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Country | US
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Telephone | 212-644-6900
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Fax | 212-644-9600
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DOUGLAS ANTHONY SCHWARTZ
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Credential | DO
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Telephone | 212-644-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 184275
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License Number State | NY
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