Provider Demographics
NPI:1982960670
Name:BLOCK MASTER PRODUCTIONS, LLC
Entity Type:Organization
Organization Name:BLOCK MASTER PRODUCTIONS, LLC
Other - Org Name:BMP POST-OP PAIN MANAGEMENT ASSOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KUTZIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-264-1127
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-0188
Mailing Address - Country:US
Mailing Address - Phone:732-264-1127
Mailing Address - Fax:732-264-0670
Practice Address - Street 1:655 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4179
Practice Address - Country:US
Practice Address - Phone:732-264-1127
Practice Address - Fax:732-264-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04931500207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty