Blanco, Alex D

Blanco, Alex D is an sole proprietor health care provider with primary practice located at 180 Lafayette Ave Apt 12A, Passaic NJ 07055-4746. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Blanco, Alex D can be contacted via phone (973) 941-3769.

Contact Information

Primary practice address
180 Lafayette Ave Apt 12A Passaic NJ 07055-4746
Phone: (973) 941-3769
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 25MD00277500 New Jersey
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X N0060221 New York

Profile Details

NPI number 1881677987
LBN Legal business name Blanco, Alex D
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 22nd, 2005
Last updated May 31st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881677987 NPPES
New Jersey MEDICAID 0018171

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