Provider Demographics
NPI:1972666360
Name:BLAU, ANTHONY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DAVID
Last Name:BLAU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:305 BROADWAY
Mailing Address - Street 2:SUITE 444
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1109
Mailing Address - Country:US
Mailing Address - Phone:212-766-4433
Mailing Address - Fax:212-608-9532
Practice Address - Street 1:305 BROADWAY
Practice Address - Street 2:SUITE 444
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1109
Practice Address - Country:US
Practice Address - Phone:212-766-4433
Practice Address - Fax:212-608-9532
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY104840207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00182352Medicaid
NY00182352Medicaid
NYC10775Medicare UPIN