Provider Demographics
NPI:1528170016
Name:PRICE, BLUMA S (RPA)
Entity type:Individual
Prefix:
First Name:BLUMA
Middle Name:S
Last Name:PRICE
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:585 SCHENECTADY AVE
Mailing Address - Street 2:MANAGED CARE DEPT. - 6TH FLOOR, BLUMBERG BLDG
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1809
Mailing Address - Country:US
Mailing Address - Phone:718-604-5469
Mailing Address - Fax:718-604-5527
Practice Address - Street 1:585 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1822
Practice Address - Country:US
Practice Address - Phone:718-604-5421
Practice Address - Fax:718-604-5527
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003283363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5204L78651Medicare PIN