Provider Demographics
NPI:1639480841
Name:BLEICH, MOSHE A (MSW/PHD)
Entity Type:Individual
Prefix:DR
First Name:MOSHE
Middle Name:A
Last Name:BLEICH
Suffix:
Gender:M
Credentials:MSW/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 US HIGHWAY 9 BLDG 5B
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8305
Mailing Address - Country:US
Mailing Address - Phone:609-901-3350
Mailing Address - Fax:609-901-3348
Practice Address - Street 1:4255 US HIGHWAY 9 BLDG 5B
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8305
Practice Address - Country:US
Practice Address - Phone:609-901-3350
Practice Address - Fax:609-901-3348
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500781891041C0700X
MD111791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical