Individual
DR. KENNETH IRA BLUMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18 SQUADRON BLVD, NEW CITY, NY 10956-5210
(845) 634-9729
(845) 708-0488
Mailing address
18 SQUADRON BLVD, NEW CITY, NY 10956-5210
(845) 634-9729
(845) 708-0488
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
173263-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01404993
—
NY
Enumeration date
10/19/2005
Last updated
12/06/2013
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