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General NPI Number Information
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NPI Number | 1801869730
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Entity Type | Individual
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Provider Name | IRWIN H BLAU MD
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 3003 NEW HYDE PARK RD SUITE 200
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1214
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Country | US
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Telephone | 516-488-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 NEW HYDE PARK ROAD 200
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City | NEW HYDE PARK
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-488-1888
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 121202
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 121202
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License Number State | NY
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