Provider Demographics
NPI:1760456933
Name:BLOCH, SANA (MD)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:BLOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:625 E FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5049
Mailing Address - Country:US
Mailing Address - Phone:718-409-3433
Mailing Address - Fax:718-933-5321
Practice Address - Street 1:625 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5049
Practice Address - Country:US
Practice Address - Phone:718-409-3433
Practice Address - Fax:718-933-5321
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1313082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01499395OtherHEALTH PLUS
NY090519000030OtherFIDELIS
NY599703POtherHIP
NY0237837OtherEMBLEM HEALTH
NY00464888Medicaid
NY000000139890OtherEMBLEM HEALTH - HMO
NY131308-A43Other131308-A43
NY7598806OtherCIGNA
NY852N21OtherEMPIRE BC BS
NY852N21OtherEMPIRE BC BS
NY0237837OtherEMBLEM HEALTH
NYA400020377Medicare PIN