Blanco, Luis A

Blanco, Luis A is an individual health care provider with primary practice located at 10211 Roosevelt Ave , Corona NY 11368-2331. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Blanco, Luis A can be contacted via phone (718) 898-1386.

Contact Information

Primary practice address
10211 Roosevelt Ave Corona NY 11368-2331
Phone: (718) 898-1386
Fax: (718) 898-1093
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 005075-1 New York

Profile Details

NPI number 1043532179
LBN Legal business name Blanco, Luis A
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2010
Last updated Apr 19th, 2018 - about 6 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 1043532179 NPPES
New York Other 005075-1 LICENSE NO

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