Physician Compare National (NPI:1912009937)

HEALTHCARE PROVIDER: MARY LANTZ LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1912009937
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092899419
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080225000318
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LANTZ
	Individual professional last name
Provider First Name	MARY
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	408 BLOOMFIELD AVE B
	Group Practice or individual's line 1 address
City	MONTCLAIR
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070423573
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9737446737
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y