Healthcare Provider Details

I. General information

NPI: 1386640993
Provider Name (Legal Business Name): STEVEN BLUESTEIN C.R.N.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

66 POWERHOUSE RD FL 3
ROSLYN HTS NY
11577-1324
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-5209
  • Fax:
Mailing address:
  • Phone: 516-626-6366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR149023
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: