| Doctor Name: | DR. SONJA BLUM |
| NPI Number: | 1003073636 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD, PHD |
| License Number: | 248370 |
| Business Practice Address: | 710 W 168th St New York, NY - 100323726 |
| Business Phone Number: | 2123056500 |
| Business Fax Number: | 2123052733 |
| Mailing Address: | 710 W 168th St, NEW YORK |
| State: | NY |
| Postal Code: | 100323726 |
| Phone Number: | 2123056500 |
| Fax Number: | 2123052733 |
| NPI Enumeration Date: | 05/21/2008 |
| NPI Last Update Date: | 05/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 248370 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |