EDISON ROQUE BLANCO

BAY SHORE, NY
NPI1184633687
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: NY  189607)
Enumeration Date2006-08-05
Last Update Date2007-07-08
Business Address
Dr. EDISON ROQUE BLANCO M.D.
16 BRENTWOOD RD
BAY SHORE, NY 11706-8011
Phone number: 631-969-7875
Mailing Address
Dr. EDISON ROQUE BLANCO M.D.
16 BRENTWOOD RD
BAY SHORE, NY 11706-8011
Phone number: 631-969-7875