Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 46TR00017700 | NJ |
N | 225XH1200X | Occupational Therapist - Hand |
NPI | 1235172131 |
---|---|
Provider Name | Mrs. Michelle K Blumenstyk |
First Address | Englewood, NJ 07631-3574 |
Second Address | Englewood, NJ 07631-3574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 20/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202370196 | HORIZON BLUE CROSS (01) | NJ |
5780436 | AETNA (01) | NJ |
J36533 | HEALTHNET (01) | NJ |
P3604499 | OXFORD (01) | NJ |