Individual
MR. MATTHEW GREGG BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
777 SEAVIEW AVE, BUILDING #2, STATEN ISLAND, NY 10305-3409
(718) 351-5530
(718) 351-5639
Mailing address
777 SEAVIEW AVE, BUILDING #2, STATEN ISLAND, NY 10305-3409
(718) 351-5530
(718) 351-5639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
13-4182492
NY
104100000X
Social Worker
058031-1
NY
Other
Enumeration date
12/12/2011
Last updated
12/15/2011
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