Provider Demographics
NPI:1144521931
Name:JENNIFER FUNG-SCHWARTZ, DPM, LLC
Entity type:Organization
Organization Name:JENNIFER FUNG-SCHWARTZ, DPM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNG-SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-678-2333
Mailing Address - Street 1:50 W 97TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6053
Mailing Address - Country:US
Mailing Address - Phone:212-678-2333
Mailing Address - Fax:212-678-2333
Practice Address - Street 1:50 W 97TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6053
Practice Address - Country:US
Practice Address - Phone:212-678-2333
Practice Address - Fax:212-678-2333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JENNIFER FUNG-SCHWARTZ, DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004889213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10204409OtherAMERIGROUP
NY6200711OtherGHI
NY18776838252OtherUNITED HEALTH CARE
NY3281902004OtherCIGNA
NY37014POtherHIP
NY1029528OtherAETNA HMO
NYNS 4207OtherOXFORD HEALTH PLANS
NY01475007Medicaid
NY5682116OtherAETNA PPO
NYU42998Medicare UPIN
NY5682116OtherAETNA PPO