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General NPI Number Information
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NPI Number | 1457593139
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Entity Type | Organization
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Legal Business Name | SVETLANA BLITSHTEYN MD PC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 100 COLLEGE PKWY STE150
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6800
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Country | US
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Telephone | 716-531-4598
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Fax | 716-478-6917
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Provider Business Mailing Address
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Address Line | 100 COLLEGE PKWY STE150
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6800
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Country | US
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Telephone | 716-531-4598
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Fax | 716-478-6917
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Authorized Official
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Title or Position | OWNER
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Name | SVETLANA BLITSHTEYN
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Credential | M.D.
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Telephone | 716-531-4598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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