Bonita Blazer, PH.D

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

302 N Washington Ave
Ste 202 - East Building
Moorestown, NJ 08057-2448

Phone

(856) 234-1270

Fax

(856) 234-0632

NPI assigned

May 10, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740494616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N WASHINGTON AVE",
            "address_2": "STE 202 - EAST BUILDING",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572448",
            "telephone_number": "856-234-1270",
            "fax_number": "856-234-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N WASHINGTON AVE",
            "address_2": "STE 202 - EAST BUILDING",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572448",
            "telephone_number": "856-234-1270",
            "fax_number": "856-234-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZER",
        "first_name": "BONITA",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Speech-Language Pathologist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.