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General NPI Number Information
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NPI Number | 1295973675
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Entity Type | Organization
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Legal Business Name | BLOCK 46521 LLC
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 54 WEST FRONT STREET
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City | KEYPORT
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State | NJ
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Zip | 07735-0000
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Country | US
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Telephone | 732-740-2205
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HURLEY ST
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City | KEYPORT
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State | NJ
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Zip | 07735-1353
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Country | US
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Telephone | 732-740-2205
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Fax | 123-456-7890
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Authorized Official
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Title or Position | CERTIFIED ACUPUNCTURIST
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Name | TED BLOCK
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Credential | C.A.
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Telephone | 732-740-2205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 25MZ00057700
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License Number State | NJ
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