Healthcare Provider Details

I. General information

NPI: 1013489913
Provider Name (Legal Business Name): JOY E BLAIR RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY E HALL

II. Dates (important events)

Enumeration Date: 12/18/2018
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 CARLTON ST
BUFFALO NY
14204-1126
US

IV. Provider business mailing address

295 CARLTON ST
BUFFALO NY
14204-1126
US

V. Phone/Fax

Practice location:
  • Phone: 716-816-3803
  • Fax: 716-851-3544
Mailing address:
  • Phone: 716-816-3803
  • Fax: 716-851-3544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number742814-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: