Individual
BONNIE BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 FRICK DR, DEMAREST, NJ 07627-1326
(845) 406-1347
(973) 506-1954
Mailing address
PO BOX 476, CRESSKILL, NJ 07626-0476
(845) 406-1347
(973) 506-1954
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA05869500
NJ
Other
Enumeration date
12/01/2006
Last updated
09/25/2015
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