Basic Information
Provider Information
NPI: 1558706069
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOROSHOW
FirstName: DEBORAH
MiddleName: BLYTHE
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 150 E 42ND ST FL 9
Address2:  
City: NEW YORK
State: NY
PostalCode: 100175699
CountryCode: US
TelephoneNumber: 6466058186
FaxNumber:  
Practice Location
Address1: 10 E 102ND ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 10029
CountryCode: US
TelephoneNumber: 2122416756
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2013
LastUpdateDate: 08/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X298953NYN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RX0202X298953NYY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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