Provider Demographics
NPI:1942224886
Name:BLANCHFIELD, PATRICK T (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:T
Last Name:BLANCHFIELD
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:PO BOX 5520
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-0520
Mailing Address - Country:US
Mailing Address - Phone:610-954-5810
Mailing Address - Fax:610-954-5480
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:610-954-5810
Practice Address - Fax:610-954-5480
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08102700207L00000X
PAMD430656207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
05663489OtherECFMG
PA104816OtherGEISINGER
PAP00427794OtherRAILROAD MEDICARE
05663489OtherECFMG
PADF2815OtherRAILROAD MEDICARE GROUP
NJ131832A01Medicare PIN
PA104816OtherGEISINGER