Individual
DR. MARY BLOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
516 KNICKERBOCKER RD, CRESSKILL, NJ 07626-1022
(201) 567-3898
(201) 567-4164
Mailing address
516 KNICKERBOCKER RD, CRESSKILL, NJ 07626-1022
(201) 567-3898
(201) 567-4164
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MA46793
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0915408
—
NJ
Enumeration date
05/18/2006
Last updated
07/12/2007
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