Provider Demographics
NPI:1639479918
Name:BLATT, BRIAN SETH (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SETH
Last Name:BLATT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W 20TH ST STE 901
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9253
Mailing Address - Country:US
Mailing Address - Phone:212-633-0783
Mailing Address - Fax:
Practice Address - Street 1:20 W 20TH ST STE 901
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9253
Practice Address - Country:US
Practice Address - Phone:212-633-0783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70 011896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor