Provider Demographics
NPI:1427151000
Name:BLUMENFELD, WALTER (MD)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:BLUMENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1341
Mailing Address - Country:US
Mailing Address - Phone:914-698-5706
Mailing Address - Fax:914-698-6624
Practice Address - Street 1:760 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-1341
Practice Address - Country:US
Practice Address - Phone:914-698-5706
Practice Address - Fax:914-698-6624
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191596207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology