MEDICARE: YEHUDA SCHWAB PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	026355	NY
2	363A00000X	Physician Assistant	026355	NY

General Provider Information

NPI Number	:	1306448378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEHUDA SCHWAB PA-C

Provider Business Mailing Address
First Line	:	841 TALBOT AVE
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-3111
Country	:	US
Telephone Number	:	845-548-2350
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 WALLABOUT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-5543
Country	:	US
Telephone Number	:	718-486-9800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	10/23/2023

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