Provider Demographics
NPI:1619033842
Name:SZMAK, DAVID GEORGE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GEORGE
Last Name:SZMAK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3582
Mailing Address - Country:US
Mailing Address - Phone:973-744-0373
Mailing Address - Fax:
Practice Address - Street 1:460 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3582
Practice Address - Country:US
Practice Address - Phone:973-744-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI2374103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ661581Medicare ID - Type Unspecified