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General NPI Number Information
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NPI Number | 1073687786
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Entity Type | Organization
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Legal Business Name | VICTORIA BLANK MD PC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 POST ROAD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6244
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Country | US
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Telephone | 203-255-1565
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Fax | 203-255-3755
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Provider Business Mailing Address
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Address Line | 400 POST ROAD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6244
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Country | US
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Telephone | 203-255-1565
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Fax | 203-255-3755
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. VICTORIA E BLANK
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Credential | MD
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Telephone | 203-255-1565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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