Provider Demographics
NPI:1376589457
Name:BLUMENTHAL, JEFFREY RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:RAY
Last Name:BLUMENTHAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-946-1500
Mailing Address - Fax:215-946-3417
Practice Address - Street 1:333 N OXFORD VALLEY RD
Practice Address - Street 2:STE 201
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2624
Practice Address - Country:US
Practice Address - Phone:215-946-1500
Practice Address - Fax:215-946-3417
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2021-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD017878E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007341320005Medicaid
PA30230773OtherKEYSTONE FIRST
PAP01193807OtherRAILROAD MEDICARE
PA0022028000OtherKEYSTONE IBC
PA9647552OtherCIGNA PA
PA058803OtherHIGHMARK BLUE SHIELD
PA4218767OtherAETNA
PA058803R52Medicare PIN
PA30230773OtherKEYSTONE FIRST