Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 1690941 | NY |
NPI | 1215988779 |
---|---|
Provider Name | Dr. Dean Bloch |
First Address | Kingston, NY 12401-5151 |
Second Address | Kingston, NY 12401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 01/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
090500769 | (05) | NY |
D92106 | (02) | NY |