Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 136547 | NY |
NPI | 1023015500 |
---|---|
Provider Name | Jody S Bleier |
First Address | Cicero, NY 13039-8715 |
Second Address | Liverpool, NY 13088-3807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 05/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00714512 | (05) | NY |
C59197 | (02) | NY |