Provider Demographics
NPI:1205721214
Name:KENNETH BLANK, M.D., P.C.
Entity type:Organization
Organization Name:KENNETH BLANK, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTIGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-564-5109
Mailing Address - Street 1:520 BROADWAY FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4436
Practice Address - Country:US
Practice Address - Phone:201-564-5109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty