Provider Demographics
NPI:1851696868
Name:BLINDER, JURI (RN)
Entity Type:Individual
Prefix:MR
First Name:JURI
Middle Name:
Last Name:BLINDER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 OLYMPIA BLVD UNIT A
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4233
Mailing Address - Country:US
Mailing Address - Phone:347-788-1888
Mailing Address - Fax:848-260-6087
Practice Address - Street 1:329 OLYMPIA BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4233
Practice Address - Country:US
Practice Address - Phone:347-788-1888
Practice Address - Fax:848-260-6087
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2013-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY621989-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse