Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV008171 | NY |
NPI | 1013321074 |
---|---|
Provider Name | Dr. Corinne E Blum |
First Address | New York, NY 10036-8005 |
Second Address | New York, NY 10036-8005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2014 |
Last Update Date | 18/06/2014 |