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General NPI Number Information
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NPI Number | 1437278033
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Entity Type | Individual
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Provider Name | VIVIAN BLUMSTEIN
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7801 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7439
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Country | US
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Telephone | 718-366-6822
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Fax |
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Provider Business Mailing Address
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Address Line | 65 WILSON RD
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City | VALLEY STREAM
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State | NY
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Zip | 11581-3417
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Country | US
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Telephone | 516-872-0061
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 002368
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License Number State | NY
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