Mary Blome, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MA46793 Issued in NJ

Practice address

516 Knickerbocker Rd
Cresskill, NJ 07626-1022

Phone

(201) 567-3898

Fax

(201) 567-4164

NPI assigned

May 18, 2006

Last updated

Jul 12, 2007By the provider in NPPES

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

Other identifiers 1

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

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1780637140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 KNICKERBOCKER RD",
            "city": "CRESSKILL",
            "state": "NJ",
            "postal_code": "076261022",
            "telephone_number": "201-567-3898",
            "fax_number": "201-567-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 KNICKERBOCKER RD",
            "city": "CRESSKILL",
            "state": "NJ",
            "postal_code": "076261022",
            "telephone_number": "201-567-3898",
            "fax_number": "201-567-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOME",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "MA46793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0915408",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alessandra Baggitt, PA-C
• Joo Jin Bahk, RPH
• Julie Lichty Balay, MS, RD, CSSD
• Alyssa Beni-Shore, LCSW LLC
• Bergen Total Health LLC
• Borough of Cresskill
• Jaime Boyce, MS CCC-SLP
• Brain Training Associates LLC (LearningRx Cresskill)
• Gary Jules Brauner, MD
• Laurie Braunstein, MA, OTR L

• Otolaryngology Physician in Cresskill, NJ
• Providers in Cresskill, NJ by specialty
• Otolaryngology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.