Provider Demographics
NPI:1053719054
Name:BARIATRIC PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BARIATRIC PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:862-252-0176
Mailing Address - Street 1:212 SHORT HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1040
Mailing Address - Country:US
Mailing Address - Phone:862-252-0176
Mailing Address - Fax:609-926-1228
Practice Address - Street 1:83 HANOVER RD
Practice Address - Street 2:SUITE 190
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1508
Practice Address - Country:US
Practice Address - Phone:973-410-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3300103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty