Provider Demographics
NPI:1770027757
Name:SCHLITZER, GEORGE ALEXANDER (DPT)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:ALEXANDER
Last Name:SCHLITZER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086-6196
Mailing Address - Country:US
Mailing Address - Phone:201-271-0800
Mailing Address - Fax:201-271-0808
Practice Address - Street 1:4100 PARK AVE
Practice Address - Street 2:
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086-6196
Practice Address - Country:US
Practice Address - Phone:201-271-0800
Practice Address - Fax:201-271-0808
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01709900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA01709900Medicare UPIN