Blaum Breast Care Specialist LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BLAUM BREAST CARE SPECIALIST LLC

Practice address

480 Pierce St
New Bridge Center, Suite #312-314
Kingston, PA 18704-5512

Phone

(570) 714-3911

Fax

(570) 714-3912

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Beth A Brennan

Title

Billing Manager

Phone

(570) 693-6163

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1467723866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST",
            "address_2": "NEW BRIDGE CENTER, SUITE #312-314",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-714-3911",
            "fax_number": "570-714-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST",
            "address_2": "NEW BRIDGE CENTER, SUITE #312-314",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-714-3911",
            "fax_number": "570-714-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAUM BREAST CARE SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "570-693-6163"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Alan Bergey, D.D.S.01
• Michelle Lauren Berley Gross, MS
• Frank A Berman, D.D.S.
• Minda Bermudez, MD
• Yashaswee Bhattarai
• Megan Bobeck, CRNP
• Robert Bogdan, LCSW
• Robert Walter Bohlander, PHD
• Bonita M Mancia M.D.
• Matthew Booth, CRNP

• All providers in Kingston, PA
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.