Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA05496100 | NJ |
NPI | 1033107347 |
---|---|
Provider Name | Steven Kirshblum |
First Address | Mechanicsburg, PA 17055-4325 |
Second Address | West Orange, NJ 07052-1424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 10/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0051004 | (05) | NJ |