Provider Demographics
NPI:1871530899
Name:GOLDBLATT, STEVEN B (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:GOLDBLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 ABRAHMS BLVD
Mailing Address - Street 2:HARTFORD HOSPITAL MEDICINE DEPT, AT HEBREW HEALTHCARE
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1508
Mailing Address - Country:US
Mailing Address - Phone:860-523-3854
Mailing Address - Fax:860-523-3828
Practice Address - Street 1:1 ABRAHMS BOULEVARD
Practice Address - Street 2:HARTFORD HOSPITAL MEDICINE DEPT, HEBREW HEALTH CARE
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117
Practice Address - Country:US
Practice Address - Phone:860-523-3854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT029225207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001292250Medicaid
CTD98110Medicare UPIN
CT001292250Medicaid