Provider Demographics
NPI:1760757215
Name:SHARLA SCHWARTZ, PT, LAC
Entity Type:Organization
Organization Name:SHARLA SCHWARTZ, PT, LAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARLA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT,LAC
Authorized Official - Phone:201-836-8430
Mailing Address - Street 1:407 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1708
Mailing Address - Country:US
Mailing Address - Phone:201-836-8430
Mailing Address - Fax:201-836-3833
Practice Address - Street 1:407 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1708
Practice Address - Country:US
Practice Address - Phone:201-836-8430
Practice Address - Fax:201-836-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00023000171100000X
NJ40QA00461500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty