=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568786648
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REGINA PAULA SCHWARZ PH.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2010
-----------------------------------------------------
Last Update Date | 03/18/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 90 BRYANT AVE SUITE BERKELEY TC
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10605-1952
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-633-6368
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 90 BRYANT AVE SUITE BERKELEY TC
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10605-1952
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-633-6368
-----------------------------------------------------
Fax | 914-632-1351
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | NYS 9421-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------