Blake-Bethea, Melrose

Blake-Bethea, Melrose is an sole proprietor health care provider with primary practice located at 774 Chancellor Ave , Irvington NJ 07111-2955. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as her primary health care specialty. Blake-Bethea, Melrose can be contacted via phone (973) 375-5882.

Contact Information

Primary practice address
774 Chancellor Ave Irvington NJ 07111-2955
Phone: (973) 375-5882
Fax: (973) 371-7990
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 25MD00228700 New Jersey

Profile Details

NPI number 1386674273
LBN Legal business name Blake-Bethea, Melrose
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386674273 NPPES
New Jersey Other 25MD00228700 PODIATRY LICENSE
New Jersey Other DO7146200 PODIATRY LICENSE

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