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Individual

DR. FREDERICK MICHAEL BLASZKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
654 E JERSEY ST, ELIZABETH, NJ 07206-1261
(908) 994-0120
(908) 994-0131
Mailing address
611 EVERGREEN PKWY, UNION, NJ 07083-8703
(908) 994-0120
(908) 994-0131

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA02971300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25MA02971300
MEDICAL LICENSE
NJ
Enumeration date
08/14/2006
Last updated
07/21/2022
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