Provider Demographics
NPI:1346395365
Name:BLATT, GLORIA J (CNS)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:J
Last Name:BLATT
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2840 LONG BEACH BLVD
Mailing Address - Street 2:STE. 440
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1516
Mailing Address - Country:US
Mailing Address - Phone:562-595-6646
Mailing Address - Fax:562-490-0434
Practice Address - Street 1:2840 LONG BEACH BLVD
Practice Address - Street 2:STE. 440
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1516
Practice Address - Country:US
Practice Address - Phone:562-595-6646
Practice Address - Fax:562-490-0434
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN327082364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative