Provider Demographics
NPI:1922362961
Name:BLUTE, MAURA E
Entity Type:Individual
Prefix:MISS
First Name:MAURA
Middle Name:E
Last Name:BLUTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MORNINGSIDE DR # 3A
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1361
Mailing Address - Country:US
Mailing Address - Phone:914-490-5693
Mailing Address - Fax:
Practice Address - Street 1:35 MORNINGSIDE DR # 3A
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1361
Practice Address - Country:US
Practice Address - Phone:914-490-5693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1213480174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist