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General NPI Number Information
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NPI Number | 1528997756
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Entity Type | Organization
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Legal Business Name | BLOSSOM MATERNITY INC
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 1303 RIVER AVE STE 103
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5699
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Country | US
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Telephone | 732-930-6369
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 RIVER AVE UNIT 3
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5695
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Country | US
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Telephone | 732-930-6369
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LIPA WALTER
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Credential |
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Telephone | 514-692-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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