Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 003306-1 | NY |
N | 2084N0600X | Clinical Neurophysiologist | 003306-1 | NY |
NPI | 1063647832 |
---|---|
Provider Name | Dr. Judith Susana Bluvstein |
First Address | New York, NY 10016-4852 |
Second Address | New York, NY 10016-4852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2009 |
Last Update Date | 26/02/2021 |