Provider Demographics
NPI:1417064973
Name:BLUEBOND, NEIL D (DO)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:D
Last Name:BLUEBOND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EARLIN AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-1780
Mailing Address - Country:US
Mailing Address - Phone:609-537-7200
Mailing Address - Fax:
Practice Address - Street 1:6 EARLIN AVE
Practice Address - Street 2:STE 290
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015
Practice Address - Country:US
Practice Address - Phone:609-537-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004744L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010067890005Medicaid
PAB37252Medicare UPIN
PA0010067890005Medicaid