Provider Demographics
NPI:1164476495
Name:BLAU, HOWARD (MD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:
Last Name:BLAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 ROUTE 27
Mailing Address - Street 2:SUITE H
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1300
Mailing Address - Country:US
Mailing Address - Phone:732-422-2300
Mailing Address - Fax:732-422-3141
Practice Address - Street 1:1950 ROUTE 27
Practice Address - Street 2:SUITE H
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1300
Practice Address - Country:US
Practice Address - Phone:732-422-2300
Practice Address - Fax:732-422-3141
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64670207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7604408Medicaid
NJP00151739OtherRAILROAD MEDICARE
NJG62991Medicare UPIN
NJP00151739OtherRAILROAD MEDICARE