Individual provider Active NPI

Jay Schmulowitz, PH.D

  • Clinical Psychologist
  • Stratford, NJ
National Provider Identifier
1962582593
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
SOI01234 Issued in NJ
Practice address
215 E Laurel Rd
Suite 201
Stratford, NJ 08084-1361
Phone
(856) 783-2322
Fax
(856) 783-0260
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X SOI01234 NJ Primary

Addresses

Primary practice location

215 E Laurel Rd
Suite 201
Stratford, NJ 08084-1361

Mailing address

215 E Laurel Rd
Suite 201
Stratford, NJ 08084-1361
Phone (856) 783-2322

Other identifiers 1

IdentifierTypeStateIssuer
071551000OtherNJMBH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SOI01234NJMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1962582593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E LAUREL RD",
            "address_2": "SUITE 201",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841361",
            "telephone_number": "856-783-2322",
            "fax_number": "856-783-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E LAUREL RD",
            "address_2": "SUITE 201",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841361",
            "telephone_number": "856-783-2322",
            "fax_number": "856-783-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMULOWITZ",
        "first_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "SOI01234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBH",
            "identifier": "071551000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.