Provider Demographics
NPI:1821183989
Name:BLUMBERG, ISABEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:S
Last Name:BLUMBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ISABEL
Other - Middle Name:S
Other - Last Name:EPSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1125 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1241
Mailing Address - Country:US
Mailing Address - Phone:917-492-9200
Mailing Address - Fax:917-492-8129
Practice Address - Street 1:1125 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1241
Practice Address - Country:US
Practice Address - Phone:917-492-9200
Practice Address - Fax:917-492-8129
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2165651207V00000X
NY216565207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H77270Medicare UPIN