Basic Information
| Provider Information | |||||||||
| NPI: | 1508111667 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BLOOD | ||||||||
| FirstName: | VINCENT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WOODS RD | ||||||||
| Address2: | |||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105951530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144936892 | ||||||||
| FaxNumber: | 9144935827 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 WOODS RD | ||||||||
| Address2: | |||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105951530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144936892 | ||||||||
| FaxNumber: | 9144935827 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2012 | ||||||||
| LastUpdateDate: | 03/06/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 213879 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2086S0102X | 213879 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.