Organization
MARTIN BLACKWELL DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN BLACKWELL D.O. (OWNER)
(973) 300-0555
Entity
Organization
Contact information
Practice address
136 WOODSIDE AVE, NEWTON, NJ 07860-2313
(973) 300-0555
(973) 300-0052
Mailing address
136 WOODSIDE AVE, NEWTON, NJ 07860-2313
(973) 300-0555
(973) 300-0052
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MB05321100
NJ
Other
Enumeration date
02/22/2012
Last updated
04/03/2012
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