Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 039933 | CT |
NPI | 1053500033 |
---|---|
Provider Name | Dr. Tamara Nathan Bloch |
First Address | Galil Tachton, ISRAEL 15295 |
Second Address | Galil Tachton, ISRAEL 15295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 16/10/2007 |