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Individual

DR. ALLA BLANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
15 WARREN ST, NEW YORK, NY 10007
(212) 226-7666
(718) 227-0132
Mailing address
11 PARK PLACE 12TH FLOOT, SUITE 1200, NEW YORK, NY 10007
(212) 226-7666
(718) 226-1039

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
204065
NY
208000000X
Pediatrics Physician
Primary
25MA07053800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01840500
NY
Enumeration date
11/22/2005
Last updated
02/02/2017
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