Basic Information
| Provider Information | |||||||||
| NPI: | 1275115545 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHWARTZ | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1480 E PECOS RD APT 2034 | ||||||||
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| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852951838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455489854 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5516 FENWAY DR | ||||||||
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| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282733976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047850560 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2021 | ||||||||
| LastUpdateDate: | 04/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 14028 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.