Provider Demographics
NPI:1306864707
Name:BLATT, RONALD D (MD, FACOG)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:BLATT
Suffix:
Gender:M
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 E 44TH ST
Mailing Address - Street 2:SUITE # 225
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4008
Mailing Address - Country:US
Mailing Address - Phone:212-308-4988
Mailing Address - Fax:212-949-4034
Practice Address - Street 1:144 E 44TH ST
Practice Address - Street 2:SUITE# 225
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4008
Practice Address - Country:US
Practice Address - Phone:212-308-4988
Practice Address - Fax:212-949-4034
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165005-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY165005OtherHIP PROVIDER ID
NY2C3087OtherHEALTHNET PROVIDER ID
NY0094565OtherGHI PROVIDER ID
NY00970645Medicaid
NYNP998OtherOXFORD PROVIDER ID
NYA63627Medicare UPIN
NYA63627Medicare UPIN