Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 162686 | NY |
NPI | 1023236569 |
---|---|
Provider Name | Dr. Karen Blau |
First Address | Dix Hills, NY 11746-4843 |
Second Address | Commack, NY 11725-4403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2007 |
Last Update Date | 08/07/2007 |