Provider Demographics
NPI:1437366168
Name:BLOSHINSKY, MARVIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:B
Last Name:BLOSHINSKY
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 1:9814 PALMA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-3500
Mailing Address - Country:US
Mailing Address - Phone:561-883-2538
Mailing Address - Fax:561-883-2538
Practice Address - Street 1:9814 PALMA VISTA WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-3500
Practice Address - Country:US
Practice Address - Phone:561-883-2538
Practice Address - Fax:561-883-2538
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094401207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB14154Medicare UPIN