Individual
MATTHEW DALLAS BLENDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
1401 FRANKLIN AVE, GARDEN CITY, NY 11530-1613
(516) 877-2626
Mailing address
1401 FRANKLIN AVE, GARDEN CITY, NY 11530-1613
(516) 877-2626
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015092
NY
Other
Enumeration date
09/19/2011
Last updated
02/26/2021
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