Juan Jorge Blanco, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

16-314 Issued in NY

Practice address

1540 Maple Rd
Williamsville, NY 14221-3647

Phone

(716) 480-2996

Fax

(716) 204-8990

NPI assigned

May 6, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1033565288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NORTHINGTON DR",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511725",
            "telephone_number": "716-480-2996",
            "fax_number": "716-204-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213647",
            "telephone_number": "716-480-2996",
            "fax_number": "716-204-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JUAN",
        "middle_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NY",
            "license": "16-314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha K Black, PA-C
• Iva Blackburn, LPN
• Maria Blackmore
• Karen Blain, NP
• Kathleen Blaisdell, LPN
• Myles Tyler Blas, PHARMD
• Mary Blauser, LPN
• Steven Michael Bleck, DDS
• Bleich, Inc.
• Bruce Bleichfeld, PH. D.

• Surgical Assistant in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Surgical Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.