Provider Demographics
NPI:1164994042
Name:BLOOD, PAUL K
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:K
Last Name:BLOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-0125
Mailing Address - Country:US
Mailing Address - Phone:908-693-5238
Mailing Address - Fax:
Practice Address - Street 1:3 PIGEON HILL RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1815
Practice Address - Country:US
Practice Address - Phone:908-693-5238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPatient Transport