Provider Demographics
NPI:1639109705
Name:GREENBLATT, DONALD W (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:W
Last Name:GREENBLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX MED
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-4861
Mailing Address - Fax:585-276-2140
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 692
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-4861
Practice Address - Fax:585-273-1058
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY142221207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00705500Medicaid
NY00705500Medicaid