Organization
FOOT & ANKLE CENTER AT ST JAMES
Active
Other names
FAMILY CARE CENTER AT ST JAMES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILIA BLANCO MD (MANAGING PHYSICIAN)
(973) 465-2790
Entity
Organization
Contact information
Practice address
228 LAFAYETTE ST, NEWARK, NJ 07105-1815
(973) 465-2790
Mailing address
66 W GILBERT ST, 2ND FLOOR, RED BANK, NJ 07701-4918
(732) 212-0051
(732) 212-0052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NJ
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NJ
207VM0101X
Maternal & Fetal Medicine Physician
—
NJ
2084P0800X
Psychiatry Physician
—
NJ
213E00000X
Podiatrist
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000027000
AMERICHOICE
NJ
01
—
1050989
HORIZON NJ HEALTH
NJ
05
—
6313507
—
NJ
05
—
6313515
—
NJ
01
—
G2055487
OXFORD
NJ
Enumeration date
12/20/2007
Last updated
07/21/2022
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