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Individual

ELIZABETH BLASCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
125 MAIN ST, ONEONTA, NY 13820-2531
(607) 433-1792
(607) 433-6519
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 433-1792
(607) 433-6608

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
217480
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02283365
NY
Enumeration date
06/02/2006
Last updated
06/08/2011
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