DR. BLAKE EDWARD BANDEFF (NPI# 1770046047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770046047 |
Entity Type | Individual |
Full Name | DR. BLAKE EDWARD BANDEFF |
Practice Address |
95 Mount Kemble Ave # 205 Morristown NJ 07960-5155 |
Mailing Address |
10682 Fort Loudon Rd Mercersburg PA 17236-9505 |
Practice Telephone | 9739717440 |
Enumeration Date | 2019-04-12 |
Last Update Date | 2019-04-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | 0 | Student, Health Care |
Street Address |
95 MOUNT KEMBLE AVE # 205 |
City | MORRISTOWN |
State | NJ |
Zip Code | 07960-5155 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710587050 | Deborah Ann Straka-demarco | Physical Therapist | 131 Madison Avenue, 3rd Floor, Morristown, NJ 07960 | 2020-10-27 |
1962009381 | Savannah Haririe | Family Medicine | 9 N Dorado Dr, Morristown, NJ 07960 | 2020-10-08 |
1063034718 | Cerebral Palsy of North Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1050 Mount Kemble Avenue, Harding, NJ 07960 | 2020-05-15 |
1154801967 | Danielle M Rediker | Physical Therapist | 25 Lindsley Drive Morristown, Nj 07960, 207, Morristown, NJ 07960 | 2018-08-21 |
1982105631 | Erin Scott | Counselor | 15 Elliott Street, Morristown, NJ 07960 | 2018-02-27 |
1992152029 | Alfre Inc. | Clinic/Center | 56 Mt Kemble Ave, Morrsitown, NJ 07960 | 2016-05-18 |
1285081588 | Pamela Marel | Social Worker | 3 First Street, Apt#2, Morristown, NJ 07960 | 2016-05-17 |
1346696671 | Community Options Enterprises, Inc | Day Training, Developmentally Disabled Services | 150 -152 Speedwell Avenue, Morristown, NJ 07960 | 2016-05-05 |
1841654274 | Matthew Olesiak | Student in an Organized Health Care Education/Training Program | 100 Madison Avenue, Morristown, Nj 07960, Morristown, NJ 07960 | 2016-04-12 |
1912372392 | Universal Rehabilitation & Fitness Center Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 41 Tiger Lily Ln, Morristown, NJ 07960 | 2015-12-10 |
Find all providers in zip 07960 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487280780 | Ambika Sharma | Student in an Organized Health Care Education/Training Program | 8 Applewood Ln, Morristown, NJ 07960-5984 | 2020-03-18 |
1841654274 | Matthew Olesiak | Student in an Organized Health Care Education/Training Program | 100 Madison Avenue, Morristown, Nj 07960, Morristown, NJ 07960 | 2016-04-12 |
1093120800 | Shivali Raav | Student in an Organized Health Care Education/Training Program | 111 Madison Ave Ste 305, Morristown, NJ 07960 | 2014-07-01 |
1912297854 | Allison Mautone | Student in an Organized Health Care Education/Training Program | 55 Alexandria Rd, Morristown, NJ 07960-3638 | 2011-04-12 |
1447456728 | Fritzgerald Estinfa | Student in an Organized Health Care Education/Training Program | 100 Madison Ave # 8, Emergency Medicine Department, Morristown, NJ 07960-6136 | 2007-06-25 |
1649885351 | Talha Iqbal | Student in an Organized Health Care Education/Training Program | 100 Madison Ave, Morristown, NJ 07960-6136 | 2020-09-09 |
1245848480 | Rebecca Hope Gilley | Student in an Organized Health Care Education/Training Program | 815 W 5th North St, Morristown, TN 37814-3810 | 2020-07-14 |
1982220240 | Jordan Nelson | Student in an Organized Health Care Education/Training Program | 100 Madison Ave, Morristown, NJ 07960-6136 | 2020-06-23 |
1851915235 | Maureen Younan | Student in an Organized Health Care Education/Training Program | 100 Madison Ave, Morristown, NJ 07960-6136 | 2020-06-02 |
1558984211 | Olivia Carol Norton | Student in an Organized Health Care Education/Training Program | 310 W 3rd North St, Morristown, TN 37814-4038 | 2020-05-28 |
Find all providers in MORRISTOWN |
City | MORRISTOWN |
Zip Code | 07960 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.