Individual
DR. DEBRA BLOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
BUREAU OF IMMUNIZATION NEW YORK STATE DEPT OFHEALTH, EMPIRE STATE PLAZA, CORNING TOWER, ROOM 649, ALBANY, NY 12237-0001
(518) 473-4437
Mailing address
BUREAU OF IMMUNIZATION NEW YORK STATE DEPT OFHEALTH, EMPIRE STATE PLAZA, CORNING TOWER, ROOM 649, ALBANY, NY 12237-0001
(518) 473-4437
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
179674-1
NY
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
179674-1
NY
Other
Enumeration date
12/30/2009
Last updated
12/30/2009
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