Provider Demographics
NPI:1619336591
Name:SCHWARTZ, JOSEPH
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RICHARD DR
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9714
Mailing Address - Country:US
Mailing Address - Phone:973-610-6974
Mailing Address - Fax:
Practice Address - Street 1:9 RICHARD DR
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9714
Practice Address - Country:US
Practice Address - Phone:973-610-6974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22-3433787251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services