Individual
DR. JUAN JORGE BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
1540 MAPLE RD, WILLIAMSVILLE, NY 14221-3647
(716) 480-2996
(716) 204-8990
Mailing address
120 NORTHINGTON DR, EAST AMHERST, NY 14051-1725
(716) 480-2996
(716) 204-8990
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
16-314
NY
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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