Blaine, Theodore

Blaine, Theodore is an individual health care provider with primary practice located at 535 E 70Th St , New York NY 10021-4823. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Blaine, Theodore can be contacted via phone (203) 705-0766.

Contact Information

Primary practice address
535 E 70Th St New York NY 10021-4823
Phone: (203) 705-0766
Fax: (860) 247-3803
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 12523 Rhode Island
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 196273-1 New York
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 39067 Connecticut
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 039067 Connecticut

Profile Details

NPI number 1376576421
LBN Legal business name Blaine, Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Dec 21st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376576421 NPPES
Connecticut Other 200001063 CT MEDICARE NUMBER

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