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General NPI Number Information
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NPI Number | 1497750079
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Entity Type | Individual
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Provider Name | MICHAEL ALAN WEINBLATT DPM
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 2100 CORLIES AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-6102
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Country | US
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Telephone | 732-775-4040
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Fax | 732-775-4060
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Provider Business Mailing Address
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Address Line | 2100 CORLIES AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-6102
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Country | US
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Telephone | 732-775-4040
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Fax | 732-775-4060
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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 | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 25MD00146000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 25MD00146000
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License Number State | NJ
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