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General NPI Number Information
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NPI Number | 1396905055
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Entity Type | Individual
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Provider Name | MERCEDES M BLANCHE MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 290 BROADWAY STE 4
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City | NEWBURGH
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State | NY
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Zip | 12550-5448
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Country | US
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Telephone | 845-764-4999
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Fax | 845-224-3979
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Provider Business Mailing Address
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Address Line | PO BOX 2955
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-8955
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Country | US
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Telephone | 845-452-2786
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Fax | 845-224-3979
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 248388
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License Number State | NY
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