Individual
KENNETH B BLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2130 MILLBURN AVE, SUITE A8, MAPLEWOOD, NJ 07040-3725
(732) 383-4166
(732) 383-4171
Mailing address
4000 ROUTE 66, SUITE 131, TINTON FALLS, NJ 07753-7300
(732) 383-4166
(732) 383-4171
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
25MA07602800
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
25MA07602800
NJ
2085U0001X
Diagnostic Ultrasound Physician
25MA07602800
NJ
Other
Enumeration date
07/04/2006
Last updated
03/23/2016
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