Provider Demographics
NPI:1457533093
Name:BRASNER BLUMBERG & AMARU MD LLP
Entity Type:Organization
Organization Name:BRASNER BLUMBERG & AMARU MD LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:QUIANA
Authorized Official - Middle Name:SHANTEL
Authorized Official - Last Name:MCCOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-492-9200
Mailing Address - Street 1:1125 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1243
Mailing Address - Country:US
Mailing Address - Phone:917-492-9200
Mailing Address - Fax:917-492-8129
Practice Address - Street 1:1125 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1243
Practice Address - Country:US
Practice Address - Phone:917-492-9200
Practice Address - Fax:917-492-8129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191295207V00000X
NY217924207V00000X
NY216565207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty