Individual
KENNETH LOUIS BLAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(203) 573-6000
Mailing address
PO BOX 676, MAINE ANESTHESIOLOGY, LEWISTON, ME 04243-0676
(800) 720-1664
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
013144
ME
207LP2900X
Pain Medicine (Anesthesiology) Physician
013144
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301770099
—
ME
Enumeration date
07/19/2006
Last updated
02/18/2019
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