Provider Demographics
NPI:1053430793
Name:MELISSA SCHWARTZ, D.O. LLC
Entity type:Organization
Organization Name:MELISSA SCHWARTZ, D.O. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:NEUMANN
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-887-7380
Mailing Address - Street 1:375 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2239
Mailing Address - Country:US
Mailing Address - Phone:215-887-7380
Mailing Address - Fax:215-887-7373
Practice Address - Street 1:375 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2239
Practice Address - Country:US
Practice Address - Phone:215-887-7380
Practice Address - Fax:215-887-7373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 007744L207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016237190002Medicaid
PAG32282Medicare UPIN
PA0016237190002Medicaid