Healthcare Provider Details

I. General information

NPI: 1679010649
Provider Name (Legal Business Name): BLUM & SAVLOV, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 RARITAN AVE SUITE 130
HIGHLAND PARK NJ
08904-2440
US

IV. Provider business mailing address

47 RARITAN AVE SUITE 130
HIGHLAND PARK NJ
08904-2440
US

V. Phone/Fax

Practice location:
  • Phone: 732-296-8047
  • Fax:
Mailing address:
  • Phone: 732-296-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3530
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC43265
License Number StateNJ

VIII. Authorized Official

Name: MR. JEFF SAVLOV
Title or Position: PARTNER
Credential: MSW
Phone: 732-296-8047