Provider Demographics
NPI:1316102999
Name:BLOCHIN, ELEN (MD)
Entity type:Individual
Prefix:
First Name:ELEN
Middle Name:
Last Name:BLOCHIN
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 1:316 E 30TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8366
Mailing Address - Country:US
Mailing Address - Phone:212-614-0039
Mailing Address - Fax:212-253-9631
Practice Address - Street 1:235 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2896
Practice Address - Country:US
Practice Address - Phone:212-599-2596
Practice Address - Fax:212-599-4554
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250697207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1316102999OtherCORVEL
VA1316102999OtherMULTIPLAN
VA1316102999Medicaid
VA1316102999OtherTRICARE/CHAMPUS
VA1316102999OtherCIGNA
VA1316102999OtherOPTIMA HEALTH
VA1316102999OtherVIRGINIA PREMIER HEALTH PLAN
VA1316102999OtherUSA MANAGED CARE
VA1316102999OtherAETNA
VA1316102999OtherUNITED HEALTHCARE
VA1316102999OtherVIRGINIA HEALTH NETWORK
VA1316102999OtherHUMANA
NC1316102999Medicaid
VA1316102999OtherCOVENTRY HEALTH CARE
VA1316102999OtherANTHEM BC/BS
VA1316102999OtherVIRGINIA HEALTH NETWORK
VA1316102999OtherVIRGINIA PREMIER HEALTH PLAN