Individual
MS. ANASTASIA BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
107 OCEAN AVE, BAY SHORE, NY 11706-8717
(631) 383-4320
Mailing address
107 OCEAN AVE, BAY SHORE, NY 11706
(631) 383-4320
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400492-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02406384
—
NY
Enumeration date
11/01/2006
Last updated
07/09/2007
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