Provider Demographics
NPI:1194746560
Name:SCHWEITZER, RICHARD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 US HIGHWAY 46 E
Mailing Address - Street 2:BUILDING B, SUITE 204
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1745
Mailing Address - Country:US
Mailing Address - Phone:973-917-3200
Mailing Address - Fax:973-917-3201
Practice Address - Street 1:100 US HIGHWAY 46 E
Practice Address - Street 2:BUILDING B, SUITE 204
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1745
Practice Address - Country:US
Practice Address - Phone:973-917-3200
Practice Address - Fax:973-917-3201
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07137900261QU0200X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ163185OtherMEDICARE PTAN