1194746560 NPI number — DR. RICHARD JOSEPH SCHWEITZER M.D.

Table of content: (NPI 1821084435)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194746560 NPI number — DR. RICHARD JOSEPH SCHWEITZER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWEITZER
Provider First Name:
RICHARD
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194746560
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 US HIGHWAY 46 E
Provider Second Line Business Mailing Address:
BUILDING B, SUITE 204
Provider Business Mailing Address City Name:
MOUNTAIN LAKES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07046-1745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-917-3200
Provider Business Mailing Address Fax Number:
973-917-3201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 US HIGHWAY 46 E
Provider Second Line Business Practice Location Address:
BUILDING B, SUITE 204
Provider Business Practice Location Address City Name:
MOUNTAIN LAKES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07046-1745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-917-3200
Provider Business Practice Location Address Fax Number:
973-917-3201
Provider Enumeration Date:
07/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , with the licence number:  25MA07137900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 25MA07137900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 163185 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".