Individual
DR. MARY CHRISSEN LOY BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
150 BROADWAY RM 1401, NEW YORK, NY 10038-4378
(212) 233-2344
Mailing address
15074 GOETHALS AVE APT 2, JAMAICA, NY 11432-1144
(917) 691-8678
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009801
NY
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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