Blank, Kenneth Robert

Blank, Kenneth Robert is an individual health care provider with primary practice located at 97 W Parkway , Pompton Plains NJ 07444-1647. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Blank, Kenneth Robert can be contacted via phone (973) 831-5306.

Contact Information

Primary practice address
97 W Parkway Pompton Plains NJ 07444-1647
Phone: (973) 831-5306
Fax: (973) 831-5305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 25MA06871100 New Jersey

Profile Details

NPI number 1205864964
LBN Legal business name Blank, Kenneth Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Aug 9th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205864964 NPPES
New Jersey MEDICAID 7930500

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