Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 205481 | NY |
Y | 207VX0201X | Gynecologic Oncologist | 205481 | NY |
NPI | 1235164120 |
---|---|
Provider Name | Benjamin Michael Schwartz |
First Address | Brightwaters, NY 11718-1830 |
Second Address | Brightwaters, NY 11718-1830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 22/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02269767 | (05) | NY |
H56445 | (02) |