Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 25MD00146000 | NJ |
N | 213ES0131X | Foot Surgery | 25MD00146000 | NJ |
NPI | 1497750079 |
---|---|
Provider Name | Dr. Michael Alan Weinblatt |
First Address | Neptune, NJ 07753-6102 |
Second Address | Neptune, NJ 07753-6102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 09/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T45351 | (02) | NJ |