Individual
DR. CHARLES J BLEIFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
48 ROUTE 25A, SUITE 106, SMITHTOWN, NY 11787-1431
(631) 863-1007
(631) 862-3668
Mailing address
48 ROUTE 25A, SUITE 106, SMITHTOWN, NY 11787-1431
(631) 863-1007
(631) 862-3668
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
103836-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
446211
EMPIRE BC/BS
NY
Enumeration date
07/24/2006
Last updated
06/09/2011
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