Provider Demographics
NPI:1962582593
Name:SCHMULOWITZ, JAY (PHD)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:
Last Name:SCHMULOWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E LAUREL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1361
Mailing Address - Country:US
Mailing Address - Phone:856-783-2322
Mailing Address - Fax:856-783-0260
Practice Address - Street 1:215 E LAUREL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1361
Practice Address - Country:US
Practice Address - Phone:856-783-2322
Practice Address - Fax:856-783-0260
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSOI01234103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ071551000OtherMBH
NJ056774Medicare ID - Type Unspecified
NJ0075055000Medicare UPIN