Individual
MRS. NATALIA BLAZHKEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1110 PENNSYLVANIA AVE, SUITE 3, BROOKLYN, NY 11207-9061
(718) 649-6677
(718) 272-0291
Mailing address
1805 215TH ST, APT 11J, BAYSIDE, NY 11360-2155
(718) 649-6677
(718) 272-0291
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
048909
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02108574
—
NY
Enumeration date
10/19/2005
Last updated
06/14/2013
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