MEDICARE: ACCU WEIGHT LOSS SYSTEM INC

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	103T00000X	Psychologist	35SI000029500	NJ

General Provider Information

NPI Number	:	1902093818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCU WEIGHT LOSS SYSTEM INC

Provider Business Mailing Address
First Line	:	412 PLEASANT VALLEY WAY
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2988
Country	:	US
Telephone Number	:	973-243-5556
Fax Number	:	973-243-5556

Provider Business Practice Location Address
First Line	:	412 PLEASANT VALLEY WAY
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2988
Country	:	US
Telephone Number	:	973-243-5556
Fax Number	:	973-243-5556

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHARLES SCHWARTZ
Credential	:	ED.D
Telephone Number	:	973-243-0777

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	02/05/2008

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