Dr. Keith R Blicht
Podiatrist
114 W Mount Pleasant Ave
Livingston
, New Jersey 07039-2932
Dr. Keith R Blicht
Podiatrist
114 W Mount Pleasant Ave
Livingston
, New Jersey 07039-2932
(973) 465-0822
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About
Features
Specialties
- Podiatrist
Languages spoken
- English
Location
First Address
- Dr. Keith R Blicht
- 254 Walnut St
- Newark, NJ
- Zip : 07105-1717
- Fax : (973) 465-0822
- Phone : (973) 465-1717
Second Address
- Dr. Keith R Blicht
- 114 W Mount Pleasant Ave
- Livingston, NJ
- Zip : 07039-2932
- Fax : (973) 994-1970
- Phone : (973) 994-2323
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 25MD00216600 | NJ |
| Y | 222Z00000X | Podiatrist | 25MD00216600 | NJ |
National Provider Identifier
| NPI | 1033147855 |
|---|---|
| Provider Name | Dr. Keith R Blicht |
| First Address | Newark, NJ 07105-1717 |
| Second Address | Livingston, NJ 07039-2932 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/06/2006 |
| Last Update Date | 16/11/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5526906 | (05) | NJ |
| U46137 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.