Provider Demographics
NPI:1346820065
Name:MUNIZ, JOHN R (D MIN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3744
Mailing Address - Country:US
Mailing Address - Phone:201-936-8885
Mailing Address - Fax:
Practice Address - Street 1:940 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3744
Practice Address - Country:US
Practice Address - Phone:201-936-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral