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General NPI Number Information
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NPI Number | 1689021529
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Entity Type | Organization
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Legal Business Name | MANHATTAN OB/GYN SURGICAL SUITES
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Dates
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Enumeration Date | 05/20/2016
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 14 DEKALB AVE FL 4
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City | BROOKLYN
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State | NY
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Zip | 11201-5311
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Country | US
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Telephone | 212-308-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 86 BROADWAY P.O. BOX 8052
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677
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Country | US
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Telephone | 404-661-4660
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RONALD DAVID BLATT
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Credential | M.D.
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Telephone | 917-658-6443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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