MARK J BLUTH (NPI# 1306817952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306817952 |
| Entity Type | Individual |
| Full Name | MARK J BLUTH |
| Credential | MD |
| Practice Address |
650 Commack Rd Commack NY 11725-5404 |
| Mailing Address |
633 3rd Ave Box 3 New York NY 10017-6706 |
| Practice Telephone | 6462273813 |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
185696 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
650 COMMACK RD |
| City | COMMACK |
| State | NY |
| Zip Code | 11725-5404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558341982 | Tiffany Troso-sandoval | Internal Medicine | 650 Commack Rd, Commack, NY 11725-5404 | 2006-01-20 |
| 1255976908 | Christine Hendriks | Pharmacist | 650 Commack Rd, Commack, NY 11725-5404 | 2019-11-16 |
| 1245702059 | Eileen Kilgus-reid | Nurse Practitioner | 650 Commack Rd, Commack, NY 11725 | 2018-12-19 |
| 1255819249 | Nicholas Paul Lattanzio | Nurse Practitioner | 650 Commack Rd, Commack, NY 11725-5404 | 2018-08-01 |
| 1750868295 | Melissa Koziatek | Nurse Practitioner | 650 Commack Rd, Commack, NY 11725-5404 | 2018-07-27 |
| 1841777307 | Sarah Jane Ray | Nurse Practitioner | 650 Commack Rd, Commack, NY 11725-5404 | 2018-07-26 |
| 1477039550 | Dana D'aconti | Nurse Practitioner | 650 Commack Rd, Commack, NY 11725-5404 | 2018-07-12 |
| 1215429659 | Serena Kuriakose | Pharmacist | 650 Commack Rd, Commack, NY 11725-5404 | 2018-06-01 |
| 1124555271 | Eileen Jackson | Nurse Practitioner | 650 Commack Rd, Commack, NY 11725-5404 | 2017-05-20 |
| 1922549369 | Frank A Surita | Pharmacist | 650 Commack Rd, Commack, NY 11725-5404 | 2017-03-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699322131 | Amanda Grace Acebedo | Student in an Organized Health Care Education/Training Program | 785 Larkfield Rd, Commack, NY 11725 | 2019-08-20 |
| 1922667716 | Diana Mcnamara | Social Worker | 13 Audrey Lane, Commack, NY 11725 | 2019-06-06 |
| 1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
| 1437661501 | Commack Chemist Inc | Pharmacy | 6216 Jericho Turnpike, Commack, NY 11725 | 2017-10-30 |
| 1285168880 | Stephanie Arico | Counselor | 14 Silver Pond Cir, Commack, NY 11725 | 2017-04-20 |
| 1235684432 | Ams Primary Medical Care House Calls,pc | Home Health | 6277 Jericho Tpk, Commack, NY 11725 | 2016-08-18 |
| 1376927459 | Min Sun Park | Dentist | All About Smiles Pediatric Dentistry, 5036 Jericho Turnpike Suite #307, Commack, NY 11725 | 2015-07-17 |
| 1467843748 | Joanna Keegan | Pharmacy Technician | 98 Veterans Memorial Highway, Commack, NY 11725 | 2015-02-09 |
| 1275936841 | Jennie Bernstein | Social Worker | 368 Veterans Hwy Ste 2, Commack, NY 11725 | 2014-09-26 |
| 1417362021 | Diana Matira Yildirim | Pediatrics | 646 Commack Road, Commack, NY 11725 | 2014-06-23 |
| Find all providers in zip 11725 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740527993 | Integrated Medical Diagnostic Services, P.C. | Radiology | 2171 Jericho Tpke, Suite 100, Commack, NY 11725-2937 | 2013-01-08 |
| 1639304165 | Vinodkumar Velayudhan | Radiology | 763 Larkfield Road, Commack, NY 11725 | 2009-05-28 |
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| 1215550462 | Hudson Valley Radiologists, PC | Radiology | 50 Leonard St Unit 106, Beacon, NY 12508-3455 | 2020-05-22 |
| 1285257519 | Hudson Valley Radiologists, PC | Radiology | 14 Hilee Rd, Rhinebeck, NY 12572-2347 | 2020-05-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.