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NPI Code Detail

MEDICARE: DR. PAUL DAVID GREENBLATT M.D.

MEDICARE: DR. PAUL DAVID GREENBLATT M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist143934NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336136787
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL DAVID GREENBLATT M.D.
Provider Business Mailing Address
First Line : PO BOX 5390
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-0279
Country : US
Telephone Number : 631-665-3666
Fax Number :
Provider Business Practice Location Address
First Line : 1855 UNION BLVD
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-7949
Country : US
Telephone Number : 631-665-3666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 02/01/2010

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