Provider Demographics
NPI:1285618843
Name:ZABLOW, BRUCE CHARLES (MD MSPH)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:CHARLES
Last Name:ZABLOW
Suffix:
Gender:M
Credentials:MD MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1600
Mailing Address - Country:US
Mailing Address - Phone:201-342-2550
Mailing Address - Fax:201-342-7171
Practice Address - Street 1:680 KINDERKAMACK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1600
Practice Address - Country:US
Practice Address - Phone:201-342-2550
Practice Address - Fax:201-342-7171
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12888612085N0700X
NJ25MA04764200207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01122201Medicaid
A64421Medicare UPIN
NYA400036939Medicare PIN