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Individual

KENNETH ROBERT BLANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
97 W PARKWAY, POMPTON PLAINS, NJ 07444-1647
(973) 831-5306
(973) 831-5305
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
25MA06871100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7930500
NJ
Enumeration date
06/29/2006
Last updated
08/09/2021
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