Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | NY 010546 | NY |
N | 103T00000X | Psychologist | NY 010546 | NY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | NY010546 | NY |
N | 103TA0700X | Adult Development & Aging Psychologist | NY010546 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | NY010546 | NY |
N | 103G00000X | Clinical Psychologist | NY 010546 | NY |
N | 103TC0700X | Clinical Psychologist | NY 010546 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | NY 010546 | NY |
N | 103TF0200X | Forensic Psychologist | NY 010546 | NY |
NPI | 1417028564 |
---|---|
Provider Name | Dr. David L Bloch |
First Address | Middletown, NY 10940-3925 |
Second Address | Middletown, NY 10940-3925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0015355 | GHI (01) | NY |
1050590 | AFFINITY (01) | NY |
110487 | MAGELLAN (01) | NY |
135316 | VALUE OPTIONS (01) | NY |
V72041 | BLUE CROSS BLUE SHIELD (01) | NY |