MEDICARE: DR. LEWIS SCHLOSSER PHD

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	103TC1900X	Counseling Psychologist	16485	NY
2	103TF0200X	Forensic Psychologist	4822	NJ

General Provider Information

NPI Number	:	1730429739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEWIS SCHLOSSER PHD

Provider Business Mailing Address
First Line	:	5 FIR CT
Second Line	:	SUITE 2 (INSTITUTE FOR FORENSIC PSYCHOLOGY)
City	:	OAKLAND
State	:	NJ
Zip	:	07436-1840
Country	:	US
Telephone Number	:	201-337-4996
Fax Number	:	201-337-8378

Provider Business Practice Location Address
First Line	:	686 LEXINGTON AVE
Second Line	:	SUITE #3N
City	:	NEW YORK
State	:	NY
Zip	:	10022-2614
Country	:	US
Telephone Number	:	646-342-5480
Fax Number	:

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

Provider Enumeration Date	:	02/27/2013
Last Update Date	:	02/27/2013

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