Organization
GREENRIDGE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORDCAI BLAU M.D, P.C (PLASTIC SURGEON)
(914) 427-4700
Entity
Organization
Contact information
Practice address
12 GREENRIDGE AVE, WHITE PLAINS, NY 10605-1238
(914) 428-4700
(914) 428-6971
Mailing address
12 GREENRIDGE AVE, WHITE PLAINS, NY 10605-1238
(914) 428-4700
(914) 428-6971
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
135936-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00478226
—
NY
Enumeration date
04/02/2007
Last updated
08/22/2020
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