Malcolm Guy Coblentz, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MA03059800 Issued in NJ

Practice address

55 Morris Ave
Suite 304
Springfield, NJ 07081-1426

Phone

(973) 486-0108

Fax

(973) 762-5151

NPI assigned

Mar 23, 2006

Last updated

May 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Malcolm Guy Coblentz, L.L.C. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1356301568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MORRIS AVE",
            "address_2": "SUITE 304",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811426",
            "telephone_number": "973-486-0108",
            "fax_number": "973-762-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MORRIS AVE",
            "address_2": "SUITE 304",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811426",
            "telephone_number": "973-486-0108",
            "fax_number": "973-762-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBLENTZ",
        "first_name": "MALCOLM",
        "middle_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA03059800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3040305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALCOLM",
            "last_name": "COBLENTZ, L.L.C.",
            "middle_name": "GUY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bernard Chelis, PH.D.
• Eleanor Lillian Cheng, MD
• Jennifer Grande Chieppa, NP-C
• Circle of Friends Inc. (NA)
• Ronald Vincent Ciuffreda, M.D.
• Barry Mark Cohen, MD
• Hayley Marks Cohen, MD
• Talia Cohen, RDN, CNSC, CDCES
• John Louis Colaizzi Jr., PHARMD, CCP
• Comfort Medical Equipment Co

• Surgery Physician in Springfield, NJ
• Providers in Springfield, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.