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General NPI Number Information
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NPI Number | 1164884409
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Entity Type | Individual
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Provider Name | REBECCA BARBARA BLANK PH.D., M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 324 E 23RD ST
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City | NEW YORK
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State | NY
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Zip | 10010-4701
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Country | US
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Telephone | 212-598-6321
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Fax | 212-598-6186
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Provider Business Mailing Address
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Address Line | 550 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 646-501-4030
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 297489
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License Number State | NY
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