Individual
MR. JERRELL FRANCIS BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
301 E 17TH ST, NURSING OFFICE, C-LEVEL, NEW YORK, NY 10003-3804
(212) 598-7674
Mailing address
25 W 13TH ST, 5MN, NEW YORK, NY 10011-7955
(917) 406-2112
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306863-1
NY
Other
Enumeration date
11/19/2014
Last updated
03/27/2015
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