Individual
DR. GRISCO S BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8900 VAN WYCK EXPY, JAMAICA QUEENS, RICHMOND HILL, NY 11418-2897
(718) 206-7095
(718) 206-7169
Mailing address
3242 87TH ST, EAST ELMHURST QUEENS, EAST ELMHURST, NY 11369-2138
(718) 651-4014
(718) 651-4014
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
170607
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01845032
—
NY
Enumeration date
10/27/2006
Last updated
07/08/2007
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