Basic Information
| Provider Information | |||||||||
| NPI: | 1790095727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHWAB | ||||||||
| FirstName: | AMIHAI | ||||||||
| MiddleName: | YISRAEL | ||||||||
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| OtherLastName: | SCHWAB | ||||||||
| OtherFirstName: | AMI | ||||||||
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| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3555 NETHERLAND AVE APT 4F | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104631643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189747429 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5676 RIVERDALE AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104712138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187965300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2010 | ||||||||
| LastUpdateDate: | 11/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.