Provider Demographics
NPI:1356448047
Name:BLECHMAN, SAMUEL (MT)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:BLECHMAN
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARK MILLS CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3203
Mailing Address - Country:US
Mailing Address - Phone:410-526-5990
Mailing Address - Fax:
Practice Address - Street 1:31 ALLEGHENY AVE
Practice Address - Street 2:104
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-3900
Practice Address - Country:US
Practice Address - Phone:410-938-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM00308225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist