Basic Information
Provider Information
NPI: 1669477436
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWARTZ
FirstName: MARSHA
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: PH.D., CCC-A, FAAA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1320 OLD CHAIN BRIDGE RD STE 185
Address2:  
City: MC LEAN
State: VA
PostalCode: 221013945
CountryCode: US
TelephoneNumber: 7038668819
FaxNumber: 8557503325
Practice Location
Address1: 133 ROLLINS AVE STE 2
Address2:  
City: ROCKVILLE
State: MD
PostalCode: 208524040
CountryCode: US
TelephoneNumber: 3014687670
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/16/2005
LastUpdateDate: 06/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237600000X00540MDN Speech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter 
231H00000X00540MDY Speech, Language and Hearing Service ProvidersAudiologist 

ID Information
IDTypeStateIssuerDescription
35565901MDALLIANCE NETWORKOTHER
L105MS01MDCAREFIRST AUDIOLOGYOTHER
35565901MDMAMSIOTHER
578919001MDAETNA PPOOTHER
35565901MDMAMSI HMOOTHER
L131AU01MDCAREFIRST HEARING AIDSOTHER
54508501MDAETNA HMOOTHER


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