Provider Demographics
NPI:1417030479
Name:BLUMSTEIN, MEYER (MD)
Entity Type:Individual
Prefix:DR
First Name:MEYER
Middle Name:
Last Name:BLUMSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563
Mailing Address - Country:US
Mailing Address - Phone:516-593-3541
Mailing Address - Fax:516-599-8307
Practice Address - Street 1:158 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563
Practice Address - Country:US
Practice Address - Phone:516-593-3541
Practice Address - Fax:516-599-8307
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173357207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01277641Medicaid
NY80F942Medicare ID - Type Unspecified
NY80F401Medicare PIN
NY01277641Medicaid
NY80F9403931Medicare PIN