Provider Demographics
NPI:1619490950
Name:MAREK BELZ LLC
Entity Type:Organization
Organization Name:MAREK BELZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOMASZ
Authorized Official - Middle Name:
Authorized Official - Last Name:OSZCZEPALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-495-8518
Mailing Address - Street 1:65 N MAPLE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3233
Mailing Address - Country:US
Mailing Address - Phone:374-840-3917
Mailing Address - Fax:
Practice Address - Street 1:65 N MAPLE AVE STE 104
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3233
Practice Address - Country:US
Practice Address - Phone:374-840-3917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA092591002084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty