Provider Demographics
NPI:1982903464
Name:MACHIN, BLANCA IRIS (RN)
Entity Type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:IRIS
Last Name:MACHIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 COLUMBIA ST APT 13J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-2619
Mailing Address - Country:US
Mailing Address - Phone:646-729-5936
Mailing Address - Fax:212-533-0961
Practice Address - Street 1:111 E 59TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1202
Practice Address - Country:US
Practice Address - Phone:121-282-1960
Practice Address - Fax:212-821-9656
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY415722163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse