Individual
BURT ROSS BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1201 LANGHORNE NEWTOWN ROAD, ST MARY MEDICAL CENTER, LANGHORNE, PA 19047
(215) 710-5900
(215) 710-6973
Mailing address
41 UNIVERSITY DR STE 300, NEWTOWN, PA 18940-1873
(215) 710-5522
(215) 710-5181
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS006397E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011712810011
—
PA
Enumeration date
04/28/2006
Last updated
05/21/2021
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