Provider Demographics
NPI:1649940651
Name:BLATNER, SYDNEY E
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:E
Last Name:BLATNER
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 1:156 LOUVAINE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2744
Mailing Address - Country:US
Mailing Address - Phone:716-239-7499
Mailing Address - Fax:
Practice Address - Street 1:2047 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-1432
Practice Address - Country:US
Practice Address - Phone:716-239-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program