Provider Demographics
NPI:1508827338
Name:BLAUSTEIN, SILVIA ADELINA (MD)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:ADELINA
Last Name:BLAUSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:ST JOSEPHS HEALTHCARE CENTER
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2000
Mailing Address - Fax:973-754-2579
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:ST JOSEPHS HEALTHCARE CENTER
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2000
Practice Address - Fax:973-754-2579
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA085085002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0190845Medicaid