18 HANS BLVD, LAKE RONKONKOMA, 11779, NEW YORK
| Entity Name | SUSAN S. BLUM, M.D., M.P.H., P.C. |
| Entity Number | 2679342 |
| Status | ACTIVE |
| Incorporation Date | 11th September 2001 |
| Dos Process Address | 1241 MAMARONECK AVE, WHITE PLAINS, 10605, NEW YORK |
| Jurisdiction | NEW YORK |
| County | WESTCHESTER |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |