Individual
JONATHAN D BLANCAFLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 SAYBROOK RD, SUITE 110, MIDDLETOWN, CT 06457
(860) 347-9167
(860) 347-1630
Mailing address
400 SAYBROOK RD, SUITE 110, MIDDLETOWN, CT 06457
(860) 347-9167
(860) 347-1630
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
030814
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001308148
—
CT
01
—
020020467
RAILROAD-MEDICARE
CT
01
—
706822
CONNECTICARE
CT
Enumeration date
12/01/2006
Last updated
05/13/2008
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