Blanco, Jesus
Blanco, Jesus is an sole proprietor health care provider with primary practice located at 104 Whalon St Suite 108, Fitchburg MA 01420-7128. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Blanco, Jesus can be contacted via phone (978) 342-1150.Contact Information
Primary practice address
104 Whalon St Suite 108
Fitchburg MA 01420-7128
Phone: (978) 342-1150
Fax: (978) 342-4530
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 56301 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 56301 | Massachusetts |
Profile Details
| NPI number | 1275590473 |
|---|---|
| LBN Legal business name | Blanco, Jesus |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2006 |
| Last updated | Feb 4th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275590473 | NPPES |
| Massachusetts | MEDICAID | 3040101 | |
| Massachusetts | Other | B75029 |
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