Organization
DENIS EDUARDO BLUMBERG LCSW-R
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENIS EDUARDO BLUMBERG LCSW-R (OWNER)
(718) 541-0884
Entity
Organization
Contact information
Practice address
285 MERRIFIELD AVE, OCEANSIDE, NY 11572-2913
(718) 541-0884
(516) 764-1097
Mailing address
5619 METROPOLITAN AVE, RIDGEWOOD, NY 11385-1958
(718) 541-0884
(718) 366-6253
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
R070766-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02847643
—
NY
Enumeration date
07/09/2009
Last updated
07/09/2009
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