Individual
DR. KEITH R BLICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
114 W MOUNT PLEASANT AVE, LIVINGSTON, NJ 07039-2932
(973) 994-2323
(973) 994-1970
Mailing address
254 WALNUT ST, NEWARK, NJ 07105-1717
(973) 465-1717
(973) 465-0822
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00216600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5526906
—
NJ
Enumeration date
06/29/2006
Last updated
11/16/2010
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