Provider Demographics
NPI:1336449479
Name:BLONDER, EVAN CARY (DVM)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:CARY
Last Name:BLONDER
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 EAST VILLAGE GREEN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756
Mailing Address - Country:US
Mailing Address - Phone:516-579-0909
Mailing Address - Fax:516-579-4707
Practice Address - Street 1:4 E VILLAGE GRN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4305
Practice Address - Country:US
Practice Address - Phone:516-579-0909
Practice Address - Fax:516-579-4707
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6448174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian