Basic Information
Provider Information
NPI: 1518131317
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BLOY
FirstName: DOROTHY
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 820956
Address2: TEMPLE PHYSICIANS INC
City: PHILADELPHIA
State: PA
PostalCode: 191820956
CountryCode: US
TelephoneNumber: 8006662455
FaxNumber: 6106176280
Practice Location
Address1: 2301 E ALLEGHENY AVE
Address2: NORTHEASTERN HOSPITAL
City: PHILADELPHIA
State: PA
PostalCode: 191344427
CountryCode: US
TelephoneNumber: 2154232376
FaxNumber: 2156344872
Other Information
ProviderEnumerationDate: 04/14/2008
LastUpdateDate: 06/07/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD433498PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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