Basic Information
| Provider Information | |||||||||
| NPI: | 1407958481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWEIGER | ||||||||
| FirstName: | BRUCE | ||||||||
| MiddleName: | DANIEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9520 63RD RD | ||||||||
| Address2: | STE J | ||||||||
| City: | REGO PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113741145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184591225 | ||||||||
| FaxNumber: | 7184595805 | ||||||||
| Practice Location | |||||||||
| Address1: | 216 NORTH AVE, EAST | ||||||||
| Address2: | |||||||||
| City: | CRANFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070162158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082727500 | ||||||||
| FaxNumber: | 9082727502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 12/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | MA69103 | NJ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 8066001 | 05 | NJ | MEDICAID |