Provider Demographics
NPI:1902093818
Name:ACCU WEIGHT LOSS SYSTEM INC
Entity Type:Organization
Organization Name:ACCU WEIGHT LOSS SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:973-243-0777
Mailing Address - Street 1:412 PLEASANT VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2988
Mailing Address - Country:US
Mailing Address - Phone:973-243-5556
Mailing Address - Fax:973-243-5556
Practice Address - Street 1:412 PLEASANT VALLEY WAY
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2988
Practice Address - Country:US
Practice Address - Phone:973-243-5556
Practice Address - Fax:973-243-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI000029500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ560462Medicare PIN