Individual
VIRGINIA BLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 UPPER MAIN ST, SUITE 7, SHARON, CT 06069-2083
(860) 364-9840
(860) 364-1859
Mailing address
251 FURNACE BROOK RD, CORNWALL BRIDGE, CT 06754-1124
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
002049
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080002049 CT 03
ANTHEM BC BS
CT
01
—
437135
MVP SPECIALIST
NY
01
—
QC4921
EMPIRE BC BS
NY
Enumeration date
05/01/2007
Last updated
07/08/2007
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