Provider Demographics
NPI:1821240052
Name:HYMOWITZ, PHILIP BRUCE (LCSW)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:BRUCE
Last Name:HYMOWITZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1206
Mailing Address - Country:US
Mailing Address - Phone:973-462-2340
Mailing Address - Fax:
Practice Address - Street 1:570 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1308
Practice Address - Country:US
Practice Address - Phone:973-450-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046647001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical