Individual
DR. MORDECAI BLUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
187 VETERAN'S BLVD, MASSAPEQUA, NY 11758
(718) 815-1000
(718) 815-8122
Mailing address
302 MANOR RD, STATEN ISLAND, NY 10314-2408
(718) 815-1000
(718) 815-8122
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
097883
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00165811
—
NY
Enumeration date
06/26/2006
Last updated
07/08/2007
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