Provider Demographics
NPI:1811096902
Name:IGNACCIO-BLATTMAN, ARLENE (MD)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:
Last Name:IGNACCIO-BLATTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ARLENE
Other - Middle Name:IGNACCIO
Other - Last Name:BLATTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:506 MALCOLM X BLVD
Mailing Address - Street 2:WP-522
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-2740
Mailing Address - Fax:212-939-2759
Practice Address - Street 1:506 MALCOLM X BLVD
Practice Address - Street 2:WP-522
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-2740
Practice Address - Fax:212-939-2759
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223305207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH57791Medicare UPIN
NY534D21Medicare ID - Type Unspecified