Provider Demographics
NPI:1538339171
Name:BLAU, ANDREA F (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:F
Last Name:BLAU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 MADISON AVE
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2511
Mailing Address - Country:US
Mailing Address - Phone:212-605-0423
Mailing Address - Fax:212-605-0247
Practice Address - Street 1:575 MADISON AVE
Practice Address - Street 2:SUITE 1006
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2511
Practice Address - Country:US
Practice Address - Phone:212-605-0423
Practice Address - Fax:212-605-0247
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist