MEDICARE: SPECIALIST PEDS AT LICH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2080P0206X	Pediatric Gastroenterology Physician
2	207N00000X	Dermatology Physician
3	2080A0000X	Pediatric Adolescent Medicine Physician
4	2080P0207X	Pediatric Hematology & Oncology Physician
5	2080P0205X	Pediatric Endocrinology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922055045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALIST PEDS AT LICH

Provider Business Mailing Address
First Line	:	160 WATER ST
Second Line	:	20FL
City	:	NEW YORK
State	:	NY
Zip	:	10038-4922
Country	:	US
Telephone Number	:	212-256-3682
Fax Number	:	212-256-3538

Provider Business Practice Location Address
First Line	:	97 AMITY ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6004
Country	:	US
Telephone Number	:	718-780-1025
Fax Number	:

Authorized Official
Title or Position	:	MANAGING EMPLOYEE
Name	:	STEVEN SCHWARZ
Credential	:	MD
Telephone Number	:	718-780-1025

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	09/11/2025

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Directions to “SPECIALIST PEDS AT LICH ” Practice Location

Language	Start Address	Practice Location

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