Individual
KENNETH SCHWARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
377 CHURCH ST, SARATOGA SPRINGS, NY 12866-8641
(518) 584-4456
(518) 584-4476
Mailing address
PO BOX 14890, SPHP PAYER CREDENTIALING, ALBANY, NY 12212
(518) 591-1121
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
170260
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01240615
MEDICAID
NY
Enumeration date
07/14/2006
Last updated
05/12/2021
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