Provider Demographics
NPI:1174066823
Name:MARKOWITZ, BLAIR
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 UNION SQ W
Mailing Address - Street 2:APT 4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3330
Mailing Address - Country:US
Mailing Address - Phone:561-251-8273
Mailing Address - Fax:
Practice Address - Street 1:15 UNION SQ W
Practice Address - Street 2:APT 4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3330
Practice Address - Country:US
Practice Address - Phone:561-251-8273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist