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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043532179 | NPPES |
| New York | Other | 005075-1 | LICENSE NO |
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