Provider Demographics
NPI:1902919319
Name:BLOCK, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:BLOCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-5900
Mailing Address - Country:US
Mailing Address - Phone:230-235-7946
Mailing Address - Fax:203-238-1418
Practice Address - Street 1:12 CURTIS ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-5900
Practice Address - Country:US
Practice Address - Phone:230-235-7946
Practice Address - Fax:203-238-1418
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT038275207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1902919319Medicaid