Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 248370 | NY |
NPI | 1003073636 |
---|---|
Provider Name | Dr. Sonja Blum |
First Address | Brooklyn, NY 11238-5073 |
Second Address | Brooklyn, NY 11238-5073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 02/08/2021 |