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General NPI Number Information
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NPI Number | 1215394051
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Entity Type | Organization
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Legal Business Name | BLUE STONE PODIATRY PLLC
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 2546 E 13TH ST APT B3
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City | BROOKLYN
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State | NY
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Zip | 11235-4306
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Country | US
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Telephone | 917-476-5791
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Fax |
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Provider Business Mailing Address
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Address Line | 2546 E 13TH ST APT B3
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City | BROOKLYN
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State | NY
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Zip | 11235-4306
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Country | US
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Telephone | 917-476-5791
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. IRINA BLUSTEIN
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Credential | DPM
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Telephone | 917-476-5791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 006614
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License Number State | NY
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