Provider Demographics
NPI:1689021529
Name:MANHATTAN OB/GYN SURGICAL SUITES
Entity type:Organization
Organization Name:MANHATTAN OB/GYN SURGICAL SUITES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BLATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-658-6443
Mailing Address - Street 1:86 BROADWAY
Mailing Address - Street 2:P.O. BOX 8052
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677
Mailing Address - Country:US
Mailing Address - Phone:404-661-4660
Mailing Address - Fax:
Practice Address - Street 1:14 DEKALB AVE FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5311
Practice Address - Country:US
Practice Address - Phone:212-308-4988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty