Individual
CHRISTIAN BLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
600 E 233RD ST, BRONX, NY 10466-2604
(718) 920-9000
Mailing address
20 W 87TH ST APT 2A, NEW YORK, NY 10024-3562
(203) 731-4669
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
X0012658062
—
NY
Enumeration date
08/02/2022
Last updated
08/11/2022
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