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General NPI Number Information
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NPI Number | 1134200561
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Entity Type | Individual
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Provider Name | RAPHAEL S BLOCH MD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MEDICAL ARTS PAVILION 3400 BAINBRIDGE AVENUE
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City | BRONX
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State | NY
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Zip | 10467
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Country | US
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Telephone | 718-920-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 20 APPLE TREE DR
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City | STAMFORD
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State | CT
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Zip | 06906-1501
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Country | US
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Telephone | 718-920-2020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 101808
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License Number State | NY
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