Provider Demographics
NPI:1225197585
Name:BRINTZ, ROBERT (CO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BRINTZ
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MUNSEY RD
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1514
Mailing Address - Country:US
Mailing Address - Phone:201-262-4330
Mailing Address - Fax:201-265-3521
Practice Address - Street 1:523 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4737
Practice Address - Country:US
Practice Address - Phone:201-262-4330
Practice Address - Fax:201-265-3521
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45OR00000500246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0441330001Medicare NSC