Individual
NESTOR D BLYZNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11794-8181
(631) 444-6996
(631) 444-7671
Mailing address
100 NICOLLS RD, STONY BROOK, NY 11794-8181
(631) 444-6996
(631) 444-7671
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
150695
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001077352
—
NY
Enumeration date
09/20/2006
Last updated
10/16/2012
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