Individual
DR. ALEX D BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
180 LAFAYETTE AVE, APT 12A, PASSAIC, NJ 07055-4746
(973) 941-3769
Mailing address
180 LAFAYETTE AVE, APT 12A, PASSAIC, NJ 07055-4746
(973) 941-3769
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00277500
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
N0060221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018171
—
NJ
Enumeration date
11/22/2005
Last updated
05/31/2016
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