EDISON R. BLANCO PHYSICIAN PC

BAY SHORE, NY
NPI1669631032
Entity TypeOrganization
Authorized ContactEDISON ROQUE BLANCO
Owner
631-969-7875
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: NY  189607)
Enumeration Date2008-06-02
Last Update Date2008-09-08
Business Address
EDISON R. BLANCO PHYSICIAN PC
16 BRENTWOOD RD
BAY SHORE, NY 11706-8011
Phone number: 631-969-7875
Mailing Address
EDISON R. BLANCO PHYSICIAN PC
16 BRENTWOOD RD
BAY SHORE, NY 11706-8011
Phone number: 631-969-7875
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