Provider Demographics
NPI:1548308547
Name:JERROLD F SCHWARTZ,M.D., LLC
Entity type:Organization
Organization Name:JERROLD F SCHWARTZ,M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JERROLD
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-357-1120
Mailing Address - Street 1:11 N AIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5103
Mailing Address - Country:US
Mailing Address - Phone:845-357-1120
Mailing Address - Fax:845-357-1141
Practice Address - Street 1:11 N AIRMONT RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5103
Practice Address - Country:US
Practice Address - Phone:845-357-1120
Practice Address - Fax:845-357-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167071207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty