Provider Demographics
NPI:1265489215
Name:BLUMENTHAL, NEIL C (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:C
Last Name:BLUMENTHAL
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 1:3435 WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2268
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:
Practice Address - Street 1:3701 CORRIERE RD STE 22
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-7991
Practice Address - Country:US
Practice Address - Phone:484-591-7170
Practice Address - Fax:484-591-7171
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49210207V00000X
PAMD042352E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0823201Medicaid
PA3709196001OtherBCBS-PA KEYSTONE EAST & AMERIHEALTH
NJ0823204Medicaid
PA50092112OtherCAPITAL BLUE CROSS
NJ160057252OtherRAILROAD MEDICARE
NJ204820112-BOtherHORIZON BC OF NJ
PA528714OtherHIGHMARK BS
NJ204820112-BOtherHORIZON BC OF NJ
NJ0823204Medicaid
PA528714OtherHIGHMARK BS