Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 137190 | NY |
N | 103T00000X | Psychologist | 137190 | NY |
NPI | 1003017443 |
---|---|
Provider Name | Dr. Mirjana Blokar |
First Address | New York, NY 10012-2420 |
Second Address | New York, NY 10012-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 02/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00367946 | (05) | NY |