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NPI Code Detail

MEDICARE: ROBERT T. HAZLETT LCSW, PH.D

MEDICARE: ROBERT T. HAZLETT LCSW, PH.D
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
1101YM0800XMental Health Counselor44SC00157900NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750327912
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT T. HAZLETT LCSW, PH.D
Provider Business Mailing Address
First Line : 4700 LONG BEACH BLVD
Second Line :
City : LONG BEACH TOWNSHIP
State : NJ
Zip : 08008-3926
Country : US
Telephone Number : 609-494-1554
Fax Number : 609-361-9553
Provider Business Practice Location Address
First Line : 4700 LONG BEACH BLVD
Second Line :
City : LONG BEACH TOWNSHIP
State : NJ
Zip : 08008-3926
Country : US
Telephone Number : 609-494-1554
Fax Number : 609-361-9553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 10/08/2007

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