Provider Demographics
NPI:1386707925
Name:SCHWARTZ, JOSEPH L J (PSYD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L J
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:L J
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD PC
Mailing Address - Street 1:156 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7314
Mailing Address - Country:US
Mailing Address - Phone:302-674-2380
Mailing Address - Fax:302-674-1299
Practice Address - Street 1:1151 WALKER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6600
Practice Address - Country:US
Practice Address - Phone:302-674-4699
Practice Address - Fax:302-674-1299
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0118231103T00000X
GAPSY002992103T00000X
DEB1-0000976103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5118232OtherWORKERS COMP
NY01449976Medicaid
133817853OtherUBH
R18889818OtherOXFORD
V94581Medicare ID - Type Unspecified
NY01449976Medicaid