Individual
DANIELLE VIOLET BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1945 US HIGHWAY 22 W, UNION, NJ 07083-8317
(908) 624-9665
Mailing address
25 CUMBERLAND RD, JERICHO, NY 11753-2639
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F421678-01
NY
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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