MEDICARE: MR. SHMUEL GANZ LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SL07397400	NJ

General Provider Information

NPI Number	:	1629933684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHMUEL GANZ LSW

Provider Business Mailing Address
First Line	:	1520 LEXINGTON AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 LEXINGTON AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1873
Country	:	US
Telephone Number	:	732-664-3943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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