Provider Demographics
NPI:1548688674
Name:BLOCH, PAUL JACOB (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JACOB
Last Name:BLOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WESCOTT DR STE 101
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4655
Mailing Address - Country:US
Mailing Address - Phone:908-782-0019
Mailing Address - Fax:
Practice Address - Street 1:1 WESCOTT DR STE 101
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4655
Practice Address - Country:US
Practice Address - Phone:908-782-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-05
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000000208800000X
TN1548688674208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes208800000XAllopathic & Osteopathic PhysiciansUrology