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General NPI Number Information
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NPI Number | 1073635421
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Entity Type | Individual
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Provider Name | BLAIR RICHARD BELTZER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 510 HAMBURG TPKE
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City | WAYNE
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State | NJ
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Zip | 07470-2025
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Country | US
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Telephone | 973-953-7668
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Fax |
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Provider Business Mailing Address
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Address Line | 525 UNION BLVD
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City | TOTOWA
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State | NJ
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Zip | 07512-2442
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Country | US
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Telephone | 973-953-7668
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Fax | 973-904-0660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA50889
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA05088900
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License Number State | NJ
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