Provider Demographics
NPI:1437317831
Name:BLUM, FRANK ELLIOTT (DC)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ELLIOTT
Last Name:BLUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:IRWIN
Other - Middle Name:FRANK
Other - Last Name:BLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:52 SKYLINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2020
Mailing Address - Country:US
Mailing Address - Phone:973-962-6230
Mailing Address - Fax:973-962-0046
Practice Address - Street 1:52 SKYLINE DRIVE
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-2020
Practice Address - Country:US
Practice Address - Phone:973-962-6230
Practice Address - Fax:973-962-0046
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00143600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor