Provider Demographics
NPI:1740268820
Name:BLINDERMAN, ARNELLE (MD)
Entity type:Individual
Prefix:DR
First Name:ARNELLE
Middle Name:
Last Name:BLINDERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N VILLAGE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3761
Mailing Address - Country:US
Mailing Address - Phone:516-764-5380
Mailing Address - Fax:516-764-1915
Practice Address - Street 1:165 N VILLAGE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3761
Practice Address - Country:US
Practice Address - Phone:516-764-5380
Practice Address - Fax:516-764-1915
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143949207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12685Medicare UPIN