Blank, Jonathan

Blank, Jonathan is an individual health care provider with primary practice located at 94 Old Short Hills Rd , Livingston NJ 07039-5672. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Blank, Jonathan can be contacted via phone (973) 322-5512.

Contact Information

Primary practice address
94 Old Short Hills Rd Livingston NJ 07039-5672
Phone: (973) 322-5512
Fax: (973) 322-8165
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MA06732600 New Jersey
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X MA06732600 New Jersey

Profile Details

NPI number 1366511412
LBN Legal business name Blank, Jonathan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Mar 9th, 2017 - about 7 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 1366511412 NPPES
New Jersey MEDICAID 7753802

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