Provider Demographics
NPI:1770625626
Name:SCHWARTZFARB, LANNY S (MD)
Entity type:Individual
Prefix:DR
First Name:LANNY
Middle Name:S
Last Name:SCHWARTZFARB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5527
Mailing Address - Country:US
Mailing Address - Phone:212-734-5670
Mailing Address - Fax:212-535-7474
Practice Address - Street 1:315 E 69TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5527
Practice Address - Country:US
Practice Address - Phone:212-734-5670
Practice Address - Fax:212-535-7474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118558207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00276311Medicaid
NY00276311Medicaid
NY319181Medicare PIN