# ALEX D BLANCO, DPM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508998824
- **Authorized official:** DR. ALEX D BLANCO (OWNER)
- **Authorized official phone:** (973) 941-3769

## Contact information

- **Practice address:** 180 LAFAYETTE AVE, APT. 12A, PASSAIC, NJ 07055-4719
- **Practice address phone:** (973) 941-3769
- **Mailing address:** 180 LAFAYETTE AVE, APT. 12A, PASSAIC, NJ 07055-4719
- **Mailing address phone:** (973) 941-3769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 25MD00277500 | NJ | Yes |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 06/01/2016