Marvin Joseph Blumenfrucht, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA03998400 Issued in NJ

Practice address

385 Tremont Ave
East Orange, NJ 07018-1023

Phone

(973) 676-1000

Fax

(212) 580-0672

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689688046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FAIRHILL RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172928",
            "telephone_number": "908-208-7381",
            "fax_number": "212-580-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000",
            "fax_number": "212-580-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENFRUCHT",
        "first_name": "MARVIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA03998400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blessed Assurance Home Health Aid
• Mariane Blouin-Gascon
• Chesney Blue, RD
• Blueprint Medical Transport
• Daniel Jack Blumenfeld, M.D.
• BMG East Orange LLC
• Catherine Bobenich
• Ann Boby Mathews
• Lamar B Bolden, OTR
• Alexis Bolivar, M.A. CCC-SLP

• Urology Physician in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.