Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MD22135 | DC |
Y | 208000000X | Pediatrician | 433698 | PA |
NPI | 1558455428 |
---|---|
Provider Name | Dr. Lynnae Schwartz |
First Address | Philadelphia, PA 19103-6535 |
Second Address | Philadelphia, PA 19103-6535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 04/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1020913200001 | (05) | PA |
177629EJL | MEDICARE PTAN (01) | PA |
E02093 | (02) |