Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 203247 | NY |
NPI | 1043211626 |
---|---|
Provider Name | Stephanie Blank |
First Address | New York, NY 10016-4750 |
Second Address | New York, NY 10016-4750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02194365 | (05) | NY |
H48387 | (02) | NY |