Individual
ELIZABETH MARIE BLOXHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
320 PENINSULA BLVD, CEDARHURST, NY 11516
(516) 569-2323
Mailing address
320 PENINSULA BLVD, CEDARHURST, NY 11516-1129
(516) 569-2323
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
289008
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05233821
—
NY
Enumeration date
03/04/2014
Last updated
04/29/2019
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