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General NPI Number Information
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NPI Number | 1477739514
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Entity Type | Organization
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Legal Business Name | DEBORAH RUIZ BLENK, M.D.,P.C.
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Dates
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Enumeration Date | 01/19/2008
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Last Update Date | 01/19/2008
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Provider Practice Location Address
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Address Line | 2900 HEMPSTEAD TPKE SUITE110
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City | LEVITTOWN
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State | NY
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Zip | 11756-1404
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Country | US
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Telephone | 516-520-4080
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Fax | 516-520-4081
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Provider Business Mailing Address
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Address Line | 2900 HEMPSTEAD TPKE SUITE110
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City | LEVITTOWN
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State | NY
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Zip | 11756-1404
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Country | US
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Telephone | 516-520-4080
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Fax | 516-520-4081
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DEBORAH RUIZ BLENK
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Credential | M.D.
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Telephone | 516-520-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 153529
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License Number State | NY
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