Doctor Name: | MS. SUSAN J BLUMENFELD |
NPI Number: | 1871742080 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNCPNP |
License Number: | 26NN08688200 |
Business Practice Address: | 250 Haddonfield Berlin Rd Suite 105 Gibbsboro, NJ - 080261228 |
Business Phone Number: | 8563460005 |
Business Fax Number: | 8567841799 |
Mailing Address: | 250 Haddonfield Berlin Rd, Suite 105 GIBBSBORO |
State: | NJ |
Postal Code: | 080261228 |
Phone Number: | 8563460005 |
Fax Number: | 8567841799 |
NPI Enumeration Date: | 09/11/2008 |
NPI Last Update Date: | 03/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 26NN08688200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |